A CARE pathway in medication-overuse headache: The experience of the Headache Centre in Pavia

Abstract

Medication-overuse headache (MOH) is one of the headache forms that most frequently prompts patients to consult a specialist headache centre. The prevaence of this form in the general population is approximately 1%-2%. Around 40% of patients seen at headache centres present with achronic form of headache and 80% of this chronic headache patients make excessive use of symptomatic drugs. MOH shows a clinical improvement, accompained by a reduction in the consumption of analgesic drugs, if patients are submitted to detoxification therapy. But detoxification is only the first stage in a long and complex course of care and global approach demands adequate follow-up visit to prevent early relapses. At the Headache Centre of the C. Mondino Institute of Neurologt in Pavia, a course of care (Care) has been developed for the complente management of patients with MOH both during Hospitalization and during the subsequent follow-up period. Care IS designed to trace the clinical, psychopathological and pharmacological profile of MOH in the short-, medium- and long-term; to look for factors possibility predictive of relapse; to assess the direct costs linked to overuse-headache in the year leading up to and following detoxification; and to evaluate disability, in terms of working days lost, before and after detoxification. © Springer-Verlag Italia 2005.