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- Jonsson, Pernilla, 1978, et al.
(författare)
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Holding on to the indispensable medication –A grounded theory on medication use from the perspective of persons with medication overuse headache
- 2013
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 14:43, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH. Methods: Data collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews. Results: The basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used. Conclusions: This qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.
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| 2. |
- Hedenrud, Tove, 1967, et al.
(författare)
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Medication Overuse Headache: Self-Perceived and Actual Knowledge Among Pharmacy Staff
- 2014
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Ingår i: Headache. - : Wiley. - 0017-8748 .- 1526-4610. ; 54:6, s. 1019-1025
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to investigate knowledge about medication overuse headache (MOH) among pharmacy staff. Background MOH is a public health problem both in Sweden and in many other countries. Persons with MOH have limited contact with health care, and medications used are to large extent over-the-counter (OTC) medications. Therefore, pharmacists have an important role in, eg, advising these individuals about their medication use. Little is, however, known about the actual level of knowledge about MOH among pharmacy staff, which determines the quality of their advice to MOH sufferers. Methods A total of 326 questionnaires were distributed to 44 pharmacies in Gothenburg, Sweden. The questionnaire included background questions, questions about advice on headache treatment, source of knowledge about MOH, and questions on self-perceived and actual knowledge on MOH. Results The response rate was 70%. A majority of the pharmacy staff (90.6%) considered themselves to have knowledge about MOH to some or a greater extent. Almost half had learned about MOH through their university/vocational education. Only 8.6% knew that all 5 headache medications listed in the questionnaire can cause development of MOH, but 40% responded correctly on which treatment advice one can give a person with MOH. Actual knowledge on treatment advice differed significantly between groups of self-perceived knowledge. Conclusion The knowledge on MOH is insufficient among pharmacy staff, but with the proper knowledge, pharmacy staff is well positioned to effect both primary and secondary prevention of MOH. We suggest not only increasing educational efforts about MOH within pharmacy programs but also continuing education at the pharmacies for all staff. Further, it is also important to increase knowledge among pharmacy customers.
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| 3. |
- Jonsson, Pernilla, 1978, et al.
(författare)
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Sociodemographic differences in medication use, health-care contacts and sickness absence among individuals with medication-overuse headache
- 2012
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 13:4, s. 281-290
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to analyse sociodemographic differences in medication use, health-care contacts and sickness absence among individuals with medication-overuse headache (MOH). A cross-sectional, population survey was conducted, in which 44,300 Swedes (a parts per thousand yen15 years old) were interviewed over telephone. In total, 799 individuals had MOH. Of these, 47 % ( = 370) only used over-the-counter medications. During the last year, 46 % ( = 343) had made a headache-related visit to their physician and 14 % ( = 102) had visited a neurologist. Among individuals aged < 30 years, the number of days/month with headache was greater than the number of days with medication use, whereas the opposite was true for those a parts per thousand yen30 years. Both the proportion using prophylactic medication and the proportion having consulted a neurologist were smaller among those who only had elementary school education than among those with higher education ( = 0.021 and = 0.046). Those with a lower level of education also had a higher number of days/month with headache and with medication use than those with a higher educational level ( = 0.011 and = 0.018). The MOH-sufferers have limited contacts with health-care and preventive measures thus need to include other actors as well. Particular efforts should be directed towards those with low educational levels, and more research on medication use in relation to age is required.
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| 5. |
- Jonsson, Pernilla, 1978, et al.
(författare)
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Epidemiology of medication overuse headache in the general Swedish population
- 2011
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 31:9, s. 1015-1022
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to estimate the prevalence of medication overuse headache (MOH) in Sweden and to analyze the occurrence of this disorder in different population groups. Methods: A total of 44,300 randomly selected individuals (55% women), aged 15 years and above, were interviewed in a national telephone survey, using a standardized questionnaire including the International Headache Society criteria for MOH and questions about sociodemographic factors, headache history and medication use. Results: In Sweden, 3.2% (95% confidence interval (CI) 3.1–3.4), n¼1428) suffer from chronic daily headache (CDH) and out of those, 56% (n¼799) have MOH. The prevalence of MOH is 1.8% (95% CI 1.7–1.9). The mean age of onset was higher among men than women as well as among those with tension-type headache as primary headache compared to those who originally had migraine. A multivariate analysis showed that socioeconomic factors such as having a low level of education and/or a low household income were associated with MOH. Conclusions: This is the first Swedish population-based study of MOH and we conclude that MOH is a significant public health problem in Sweden, as it is in other parts of the world.
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| 6. |
- Linde, Mattias, 1966, et al.
(författare)
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Adherence to migraine prophylaxis at a Swedish tertiary clinic. A cross-sectional study of influence of disease features
- 2007
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Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007.
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Konferensbidrag (refereegranskat)abstract
- Introduction The efficacy of mainly the more recently developed prophylactic treatments of migraine have been well established in a large number of randomised controlled trials. However, such trials tend to focus on the effects of the drug in an ideal setting and rather underestimate the impact of non-compliance, which generally escapes detection by the physician. This poorly understood phenomenon was further looked at in a naturalistic setting. Methods A consecutive sample of 175 migraineurs (85% women, mean age 4512, range 19-79 years) with a current prescription of pharmacological prophylaxis were studied at a Swedish headache specialist clinic. Adherence was self-reported with the Medication Adherence Report Scale (MARS, possible range of scores 5-25). Logistic regression analysis was performed to analyze the association between MARS and frequency of attacks, number of days with migraine per month, attack duration, presence of prodrome (68%), presence of aura (41%, some or all attacks), mean intensity of pain, and recovery between attacks. Results The mean frequency of migraine was 6.5 days / month, and 68% did not recover completely interictally. The mean MARS score was 22.52.8. One third (35%) was not highly adherent. Neither demographic characteristics, nor any of the studied disease specific variables were significantly associated with adherence. Discussion The full benefit of prophylactic migraine medication cannot be realised at currently achieved levels of adherence. Characteristics of the headaches per se are the starting point of patients’ decision-making. However, the present study indicates that other factors play a more important role in this complicated process.
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| 7. |
- Jonsson, Pernilla, 1978
(författare)
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Problematic medication use in headache - Epidemiology and qualitative aspects of medication overuse headache and non-adherence to prophylactic migraine treatment
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim was to analyze problematic medication use among persons with headache, focusing on overuse of acute medications, with subsequent medication overuse headache (MOH), and on underuse of prophylactic medication. Methods: Data in Studies I and II came from a population survey in which 44 300 Swedes were interviewed by telephone about headache and medication use. In Study III, a questionnaire concerning adherence and beliefs about medicines was distributed to 174 consecutive migraine patients at a headache clinic. Study IV was a qualitative study, using grounded theory, in which 14 individual interviews were conducted with persons who fulfilled the diagnostic criteria for MOH. Results: The prevalence of MOH in Sweden was 1.8% (95% C.I. 1.7–1.9). It was 2.8 times more common among women than among men and inversely associated with socioeconomic status. Fewer than half of those with MOH had made a headache-related visit to a physician during the previous year, and almost half used only over-the-counter (OTC) medications to treat their headaches. The proportion only using OTC medications was particularly high among the young. There were several differences indicating that the use of medications and the rate of health care contacts were unequal in relation to educational level. As for use of prophylactic medications, approximately one third of the migraineurs were considered non-adherent. The participants in the qualitative study perceived headaches as something that threatened to ruin their lives, and despite extensive efforts, they were unable to find any effective aid other than the acute medication. Because of this, the acute medication became indispensable to them. Conclusion: Both overuse of acute medication and underuse of prophylactic medication are significant problems among persons with headache. Since both problems may lead to increased headaches, it is likely that many persons with headache carry an unnecessarily high disease burden.
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| 8. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Vibration related symptoms and signs in quarry and foundry workers
- 2021
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 94
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The development of vascular and neurosensory findings were studied in two groups of long-term exposed quarry and foundry workers with different vibration exposures, working conditions and work tasks. Methods The study included 10 quarry workers (mean age 43 yrs., mean exposure time 16 yrs.) and 15 foundry workers (35 yrs.; 11 yrs.) at two plants in Sweden. All participants completed a basic questionnaire and passed a medical examination including a number of neurosensory tests, e.g. the determination of vibration (VPT) and temperature (TPT) perception thresholds as well as a musculoskeletal examination of the neck, shoulders, arms and hands. Results A high prevalence of neurosensory findings (40%) was found among the quarry workers. Both groups, however, showed a low prevalence of vibration white fingers (VWF). Foundry workers showed significantly better sensitivity than quarry workers for all monofilament tests (p <= 0.016), TPT warmth in dig 2 (p = 0.048) and 5 dexter (p = 0.008), and in dig 5 sinister (p = 0.005). They also showed a better VPT performance in dig 5 dexter (p = 0.031). Conclusions Despite high vibration exposure, the prevalence of VWF was low. The high prevalence of neurosensory findings among the quarry workers may depend on higher A(8) vibration exposure and higher exposure to high-frequency vibrations. An age-effect and exposure to cold could also be contributing factors. The nervous system seems to be more susceptible to high-frequency vibrations than the vascular system. For neurosensory injuries, the current ISO 5349-1 standard is not applicable.
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| 9. |
- Hedenrud, Tove, 1967, et al.
(författare)
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Beliefs about medicines and adherence among Swedish migraineurs.
- 2007
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Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007..
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Konferensbidrag (refereegranskat)abstract
- Objective The aim was to analyze whether beliefs about medicines are associated with adherence to prophylactic medication among Swedish migraineurs. Methods A questionnaire was distributed consecutively to migraineurs attending a tertiary clinic. All participants were prescribed prophylactic medication. The questionnaire comprised e.g. background questions, beliefs about medicines (BMQ), and self-reported adherence (MARS). The General BMQ comprises three subparts: General Harm, General Overuse, and General Benefit. The specific part of the BMQ has two subparts: Specific Necessity and Specific Concerns. For the BMQ Specific, a necessity–concerns differential was calculated for each participant. A logistic regression analysis was performed to analyze the association between beliefs about medicines and adherence to prophylactic medication. Results Of the 175 participants, 15% were male and more than half of the participants were aged 45 years and over. Fifty percent had a university degree. Sixty-four percent were considered adherent. There was no significant difference in adherence between gender, age groups, or by educational level. Respondents with only compulsory school were less concerned about the long-term effects of medications and had a higher necessity–concern differential. In the logistic regression analysis, no variable was significantly associated with adherence. Conclusions The present study showed no association between beliefs about medication and adherence. We recommend that lack of adherence to migraine prophylactic drugs should be considered more often, looked for, and addressed in order to identify sufferers with an unnecessarily high migraine-associated disability. This assumes greater attention to the problem amongst both physicians and researchers in all countries.
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