Chronic migraine with medication overuse: Association between disability and quality of life measures, and impact of disease on patients' lives

• Published in: Journal of the neurological sciences 2015-01, Vol.348 (1), p.60-66
• Main Authors: Raggi, Alberto, Schiavolin, Silvia, Leonardi, Matilde, Giovannetti, Ambra Mara, Bussone, Gennaro, Curone, Marcella, Di Fiore, Paola, Grazzi, Licia, Usai, Susanna, D'Amico, Domenico
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Chronic Disease; Chronic migraine; Detoxification; Disability; Disability Evaluation; Female; Health-related quality of life; Humans; Male; Medication overuse; Middle Aged; Migraine Disorders - chemically induced; Migraine Disorders - diagnosis; Neurology; Prescription Drug Overuse - adverse effects; Quality of Life; Severity of Illness Index; Withdrawal; Young Adult
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2014.11.004

Abstract Patients with chronic migraine with medication overuse (CM-MO) have decreased quality of life (QoL) and increased disability: the degree to which these outcomes are connected to disease severity and the pattern of MO towards disease severity are unclear. Patients under withdrawal were administered the Migraine Disability Assessment (MIDAS), the WHO Disability Assessment Schedule (WHODAS), and the Migraine-Specific Quality of Life Questionnaire (MSQ). They overused NSAIDs, triptans, NSAIDs and triptans, and other drugs (ergotamine, caffeine, opioids/barbiturates). We calculated the correlations between MIDAS, WHODAS, and MSQ; compared WHODAS to normative scores; compared MIDAS, WHODAS, and MSQ in patients with different CM-MO severity; and run a logistic regression to predict CM-MO severity based on overused drugs. One hundred ninety-four patients were enrolled: correlations between WHODAS, MSQ, and MIDAS were moderate; wide differences on WHODAS against normative were found; and no trend was found across severity groups. Compared to triptans overusers, patients overusing NSAID and other drugs had higher odds of severe CM-MO. Coupling different disability measures with QoL assessment offered different insights on the lived experience of CM-MO. Future studies are needed to clarify the relationship between overused drugs and CM-MO severity: we added evidence that NSAIDs do not have protective effect in high-frequency CM-MO.