Patterns of medication use by chronic and episodic headache sufferers in the general population: Results from the frequent headache epidemiology study
Patterns of medication use by chronic and episodic headache sufferers in the general population: Results from the frequent headache epidemiology study
复制标题
DOI：
10.1111/j.1468-2982.2009.01913.x
复制
发表时间：
2010-03-01
期刊：
影响因子：
4.9
通讯作者：
Bigal, M.
中科院分区：
文献类型：
--
作者：
Scher, A. I.;Lipton, R. B.;Bigal, M.
虽然有症状的药物过度使用被认为在从发作性头痛（EH）到慢性每日头痛（CDH）的进展中发挥作用，但关于这一主题的基于人群的数据有限。我们的目的是描述一般人群样本中CDH和EH患者的药物使用模式。我们比较了用于治疗CDH病例和EH对照头痛的药物，这些药物是通过一项基于大量人群的计算机辅助电话访谈调查确定的。鼎晖开始在5年内的计算机辅助电话采访。关于药物使用的问题主要集中在CDH病例发病前的治疗和对照组过去相当时期的治疗。我们询问了治疗的可能性，等待治疗的时间，使用的不同药物的数量，第一，第二和第三最常用的头痛药物，以及总治疗天数。还询问了关于使用非头痛药物的问题。评估当前治疗模式和既往治疗模式。在调整年龄、性别、原发性头痛类型和治疗疼痛的药物数量后，比较CDH病例和EH对照组使用特定药物的可能性。我们的样本包括206例CDH和507例EH对照。CDH受试者比EH对照者更可能使用非处方药/咖啡因组合产品、曲坦类药物、阿片类化合物和“其他”处方止痛药。服用阿司匹林具有保护作用。调整后，阿司匹林和布洛芬与CDH呈（负）相关[OR 0.5（0.3-0.9），OR 0.7（0.5-1.0）]，阿片类药物与CDH呈正相关[OR 2.3（1.3-3.9）]。对于既往使用，CDH与非处方药/咖啡因组合产品和阿片类化合物呈正相关，与阿司匹林的使用呈负相关。调整后，只有布洛芬与CDH保持（负）相关[OR 0.6（0.4-0.9）]。在调整人口因素、原发性头痛类型和服用药物数量后，CDH患者比EH患者更有可能使用阿片类组合镇痛药，而不太可能使用阿司匹林或布洛芬。
Though symptomatic medication overuse is believed to play a role in progression from episodic headaches (EH) to chronic daily headaches (CDH), population-based data on this topic are limited. Our objective was to describe patterns of medication use among CDH and EH sufferers in a general population sample. We compared medications used to treat headache in CDH cases and EH controls identified from a large population-based computer-assisted telephone interview survey. CDH began within 5 years of the computer-assisted telephone interview. Questions on medication use focused on treatment prior to the onset of CDH for cases and on an equivalent period in the past for controls. We asked about the likelihood of treating, time waiting to treat, number of different medications used, first, second and third most frequently used headache pain medication, and total treatment days. Questions were also asked about the use of medication for non-headache pain. Current treatment patterns and past treatment patterns were assessed. Likelihood of use of specific medications was compared between CDH cases and EH controls after adjusting for age, sex, primary headache type and number of medications taken to treat pain. Our sample consists of 206 CDH cases and 507 EH controls. CDH subjects were more likely than EH controls to use over-the-counter/caffeine combination products, triptans, opioid compounds and 'other' prescription pain medications. Use of aspirin was protective. After adjustment, aspirin and ibuprofen were (negatively) associated with CDH [OR 0.5 (0.3-0.9), OR 0.7 (0.5-1.0)] and opioids remained positively associated with CDH [OR 2.3 (1.3-3.9)]. For past use, CDH was positively associated with over-the-counter/caffeine combination products and opioid compounds and was negatively associated with use of aspirin. Only ibuprofen remained (negatively) associated with CDH after adjustment [OR 0.6 (0.4-0.9)]. After adjusting for demographic factors, primary headache type and number of medications taken, CDH sufferers are more likely to use opioid-combination analgesics, and less likely to use aspirin or ibuprofen, than EH sufferers.