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Medication use in patients with migraine and medication-overuse headache: The role of problem-solving and attitudes about pain medication

Lauwerier, Emeliena,*; Paemeleire, Koenb; Van Damme, Stefaana; Goubert, Liesbeta; Crombez, Geerta

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doi: 10.1016/j.pain.2011.02.014

Excessive medication intake is a risk factor for the development of medication-overuse headache (MOH), a condition characterized by an increase of headache frequency to a daily or near-daily pattern. As yet, it is largely unknown why some patients overuse medication. In this study, we examined to what extent attitudes about pain medication, especially perceived need and concerns, and problem-solving are related to MOH. Patients with migraine (n = 133) and MOH with a history of migraine (n = 42) were recruited from a tertiary headache referral center and completed questionnaires measuring problem-solving and attitudes about pain medication. A problem-solving mode aimed at solving pain was associated with a higher need for and concerns about medication intake. Interestingly, in a model accounting for demographic factors and pain intensity, attempts to control pain, need for medication, and concerns about scrutiny by others because of medication intake all had a unique value in accounting for MOH. Results are discussed in terms of how repeated attempts to solve pain may trigger overuse of medication, even in the presence of clear negative consequences.

Repeated attempts at solving pain may increase the need for analgesic medication, despite obvious costs. This mechanism might contribute to the problem of medication-overuse headache.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

aDepartment of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium

bDepartment of Neurology, Ghent University Hospital, Ghent, Belgium

*Corresponding author. Address: Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, Ghent B-9000, Belgium. Tel.: +32 9 264 91 06, fax: +32 9 264 64 89.


Article history: Received 5 July 2010; Received in revised form 16 December 2010; Accepted 4 February 2011.

© 2011 Lippincott Williams & Wilkins, Inc.
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