Title: Study of Clinical Profile of Patients with Medication Overuse Headache in India
Authors: Debsadhan Biswas, Koustav Jana
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.67
Abstract
Background: Indian data on Medication overuse headache (MOH) is sparse and inadequate. Hence this prospective observational study was conducted.
Aim: To study the socio-demographic and clinical profile of patients with MOH.
Material and Methods: 42 consecutive patients; age ≥ 18 years, fulfilling the diagnostic criteria of MOH according to ICDH-3 Beta were enrolled in the study from Neurology OPD between March 2017 to April 2019 after excluding patients with secondary causes of headache and those who denied consent. Socio-demographic and clinical data of those were recorded using a pre-designed proforma and analyzed using descriptive statistics.
Results: The study revealed female predominance (85.7%) among the study subjects with a mean age of 34.7 years; most (40.5%) were between 31-40 years of age. Most of the patients received education up to primary (30.9%) or secondary level (40.5%) and were from the lower (26.2), upper lower (45.2%) or the lower middle (21.4%) socio-economic class. Migraine (54.7%) was the most common primary underlying headache type, followed by Tension type headache (40.5%); mean duration of headache being 4.5 years. Most common overused medication was non-opioid containing combination analgesics (50%). 11.9% patients were obese and 33.3% were overweight; 19% fulfilled the WHO criteria for inactivity. Prior stressful life event was found in 11.9% patients, chronic musculoskeletal pain in 23.8% and sleep disturbances in 80.9% patients. 73.8% patients suffered from depression while 57.1% suffered from anxiety. 64.3% had a prior visit to a qualified physician for headache. None of the patients maintained a headache diary and none were cautioned previously against medication overuse.
Conclusion: Along with low educational and socio-economic status, easy availability of over-the-counter pain medications, lack of awareness regarding their overuse contribute to MOH in Indian scenario.
Keywords: Medication overuse headache, MOH.
