A CARE pathway in medication–overuseheadache: the experience of the HeadacheCentre in Pavia

摘要

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 a chronic 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 firststage in a long and complex courseof care and global approachdemands adequate follow–up visitto prevent early relapses. At theHeadache Centre of the C. MondinoInstitute of Neurologt in Pavia, acourse of care (CARE) has beendeveloped for the complente managementof patients with MOH bothduring Hospitalization and durimgthe subsequent follow–up period.CARE IS designed to trace the clinical,psychopathological and pharmacologicalprofile of MOH in theshort–, medium– and long–term; tolook for factors possibility predictiveof relapse; to assess the directcosts linked to overuse–headache inthe year leading up to and followingdetoxification; and to evaluatedisability, in terms of working dayslost, before and after detoxification.