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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. |
- 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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| 3. |
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| 4. |
- 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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| 5. |
- 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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| 6. |
- 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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