Samenvatting
Objective: to assess clinical outcome of patients with migraine, tension type headache (TTH) and medication overuse headache (MOH) by means of the Headache Impact Test (HIT-6) score and Global Perceived Effect (GPE)
Methods
Between December 2008 and April 2011, patients attending a headache clinic who were diagnosed as TTH, migraine or MOH and of whom follow-up data were available were prospectively included
All patients completed a HIT-6 questionnaire at baseline and on follow-up
The clinical outcome on follow-up was assessed by means of the GPE (with scores of 1, 2 and 3 respectively meaning strong, moderate and slight improvement -4 meaning no change -5, 6 and 7 respectively implicating slight, moderate and strong deterioration)
GPE data were dichotomized into improved(i.e. slightly, moderately or strongly improved)and not improvedon follow-up (i.e. stable or worse clinical condition)
Results
291 patients (182 migraine, 59 TTH and 50 MOH) were included
79% female patients, Age = 37 +/-14 years (mean +/-SD) 51% had ? 15 headache days/month In 66% of all patients, a preventive therapy was started (65% for migraine, 82% for MOH and 52% for TTH)
Median follow-up was 7 weeks (interquartile range 6-10) HIT-6 score on baseline was 65 +/-7 (mean +/-SD)
A favorable clinical evolution (GPE 1, 2 or 3) was seen in 222 patients (76%)
Best responses were obtained for migraine and MOH patients (78% of patients) opposed to TTH patients (71%)(not significant -Fisher's exact test)
HIT-6 score on follow-up decreased 61 +/-7 on follow-up (p <0.0001, compared to baseline; paired two-tailed t test)
Of those patients with a subjective favorable clinical evolution, the HIT-6 score on follow-up decreased even more (60 +/-7
Still 54% of patients with a favorable clinical evolution had a HIT-6 score on follow-up ?60(headache interferes strongly with activities of daily living)
Conclusions
More than 75% of patients visiting a headache clinic have a favorable clinical evolution
However, approximately half of the patients with an assumed favorable clinical evolution still have headaches that strongly interfere with daily life
The latter reflects a tendency towards headache chronification, possibly leading to subsequent medication overuse and highlighting the need for better treatment modalities both concerning acute and preventive treatment
Methods
Between December 2008 and April 2011, patients attending a headache clinic who were diagnosed as TTH, migraine or MOH and of whom follow-up data were available were prospectively included
All patients completed a HIT-6 questionnaire at baseline and on follow-up
The clinical outcome on follow-up was assessed by means of the GPE (with scores of 1, 2 and 3 respectively meaning strong, moderate and slight improvement -4 meaning no change -5, 6 and 7 respectively implicating slight, moderate and strong deterioration)
GPE data were dichotomized into improved(i.e. slightly, moderately or strongly improved)and not improvedon follow-up (i.e. stable or worse clinical condition)
Results
291 patients (182 migraine, 59 TTH and 50 MOH) were included
79% female patients, Age = 37 +/-14 years (mean +/-SD) 51% had ? 15 headache days/month In 66% of all patients, a preventive therapy was started (65% for migraine, 82% for MOH and 52% for TTH)
Median follow-up was 7 weeks (interquartile range 6-10) HIT-6 score on baseline was 65 +/-7 (mean +/-SD)
A favorable clinical evolution (GPE 1, 2 or 3) was seen in 222 patients (76%)
Best responses were obtained for migraine and MOH patients (78% of patients) opposed to TTH patients (71%)(not significant -Fisher's exact test)
HIT-6 score on follow-up decreased 61 +/-7 on follow-up (p <0.0001, compared to baseline; paired two-tailed t test)
Of those patients with a subjective favorable clinical evolution, the HIT-6 score on follow-up decreased even more (60 +/-7
Still 54% of patients with a favorable clinical evolution had a HIT-6 score on follow-up ?60(headache interferes strongly with activities of daily living)
Conclusions
More than 75% of patients visiting a headache clinic have a favorable clinical evolution
However, approximately half of the patients with an assumed favorable clinical evolution still have headaches that strongly interfere with daily life
The latter reflects a tendency towards headache chronification, possibly leading to subsequent medication overuse and highlighting the need for better treatment modalities both concerning acute and preventive treatment
| Originele taal-2 | English |
|---|---|
| Pagina's (van-tot) | 208 |
| Aantal pagina's | 1 |
| Tijdschrift | Cephalalgia |
| Volume | S1 |
| Nummer van het tijdschrift | 31 |
| Status | Published - 2012 |
| Evenement | Unknown - Duur: 1 jan. 2012 → … |