Prevalence of chronic headache with and without medication overuse: Associations with socioeconomic position and physical and mental health status

• Published in: Pain (Amsterdam) Vol. 155; no. 10; pp. 2005 - 2013
• Main Authors: Westergaard, Maria Lurenda, Glümer, Charlotte, Hansen, Ebba Holme, Jensen, Rigmor Højland
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier B.V 01.10.2014; International Association for the Study of Pain; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analgesics - adverse effects; Analgesics - therapeutic use; Biological and medical sciences; Chronic headache; Cross-Sectional Studies; Denmark - epidemiology; Disability; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Headache - drug therapy; Headache - epidemiology; Headache Disorders, Secondary - drug therapy; Headache Disorders, Secondary - epidemiology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Health Status; Humans; Male; Medical sciences; Medication-overuse headache; Mental Health; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Prevalence; Quality of life; Registries; Risk Factors; Social Class; Socioeconomic Factors; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors; Vertebrates: nervous system and sense organs; Young Adult; Denmark; Disability; Medication-overuse headache; Prevalence; Chronic headache; Socioeconomic factors; Epidemiology; Quality of life; Headache; Nervous system diseases; Socioeconomic status; Mental health; Chronic; Pain; Health status; Sociodemographic factor; Neurological disorder; Public health; Comparative study
• DOI: 10.1016/j.pain.2014.07.002
• ISSN: 0304-3959; 1872-6623

Chronic headache prevalence in Denmark was inversely related to socioeconomic position, but significant ill health was seen among persons with chronic headache in all socioeconomic strata. Near-daily intake of acute symptomatic medication for frequent headache increases the risk for medication-overuse headache (MOH). Chronic headache (CH) and MOH prevalences are inversely related to socioeconomic position (SEP). It is not known how SEP influences the health status of people with these headaches. This cross-sectional study examined the prevalence of CH in Denmark; possible associations between CH and education, work status, and income; and the health status of people with CH across socioeconomic strata. A total of 129,150 individuals aged ⩾16years were invited to the 2010 Danish National Health Survey. Data on SEP indicators and purchases of prescription drugs in 2009 were retrieved from national registers. Respondents with headache ⩾15days per month over 3months were classified as having CH. Those with concurrent over-the-counter analgesic intake of ⩾15days per month or prescription medication overuse (⩾20 or ⩾30 defined daily doses per month depending on the drug or drugs) were classified as having MOH. Associations between headache and SEP were analyzed by logistic regression, and associations between headache and health status scores, by linear regression. Physical and mental health composite scores (SF-12) were summarized per headache group, stratified by SEP, and compared to the sample mean. Analyses were adjusted for stratified sampling and nonresponse. The response rate was 53.1%. CH prevalence was 3.3% with 53.0% of cases having concurrent medication overuse (MOH prevalence 1.8%). CH was more prevalent among those individuals with low SEP. Health status scores were significantly lower among persons with CH in all SEP categories. The burden of CH can be reduced by preventing and treating MOH.