000K  utf8
1100  2018$c2018-06-27
1500  eng
2050  urn:nbn:de:hbz:464-20210510-111432-4
2051  10.1177/0333102418783317
3000  Bottiroli, Sara
3010  Allena, Marta
3010  Avenali, Micol
3010  Bendtsen, Lars
3010  De Icco, Roberto
3010  Fadic, Ricardo
3010  Goicoechea, Maria Teresa
3010  Jensen, Rigmor Højland
3010  Katsarava, Zaza
3010  Lainez, Miguel J. A.
3010  Nappi, Giuseppe
3010  Sances, Grazia
3010  Tassorelli, Cristina
4000  Psychological, clinical, and therapeutic predictors of the outcome of detoxification in a large clinical population of medication-overuse headache$da six-month follow-up of the COMOESTAS Project  [Bottiroli, Sara]
4209  Aim: To identify factors that may be predictors of the outcome of a detoxification treatment in medication-overuse headache. Methods: Consecutive patients entering a detoxification program in six centres in Europe and Latin America were evaluated and followed up for 6 months. We evaluated anxious and depressive symptomatology (though patients with severe psychiatric comorbidity were excluded), quality of life, headache-related disability, headache characteristics, and prophylaxis upon discharge. Results: Of the 492 patients who completed the six-month follow up, 407 ceased overuse following the detoxification (non overusers), another 23 ceased overuse following detoxification but relapsed during the follow-up. In the 407 non-overusers, headache acquired an episodic pattern in 287 subjects (responders). At the multivariate analyses, lower depression scores (odds ratio = 0.891; p  = 0.001) predicted ceasing overuse. The primary headache diagnosis – migraine with respect to tension-type headache (odds ratio = 0.224; p  = 0.001) or migraine plus tension-type headache (odds ratio = 0.467; p  = 0.002) – and the preventive treatment with flunarizine (compared to no such treatment) (odds ratio = 0.891; p  = 0.001) predicted being a responder. A longer duration of chronic headache (odds ratio = 1.053; p  = 0.032) predicted relapse into overuse. Quality of life and disability were not associated with any of the outcomes. Conclusions: Though exploratory in nature, these findings point to specific factors that are associated with a positive outcome of medication-overuse headache management, while identifying others that may be associated with a negative outcome. Evaluation of the presence/absence of these factors may help to optimize the management of this challenging groups of chronic headache sufferers.
4950  https://doi.org/10.1177/0333102418783317$xR$3Volltext$534
4950  https://nbn-resolving.org/urn:nbn:de:hbz:464-20210510-111432-4$xR$3Volltext$534
4961  https://duepublico2.uni-due.de/receive/duepublico_mods_00071851
5051  150
5051  610
5550  anxiety
5550  depression
5550  disability
5550  quality of life
5550  relapse
5550  Withdrawal