Determinants of pain interference and headache impact in patients who have chronic migraine with medication overuse: Results from the MOTS trial

Author:

Schwedt Todd J1,Sahai-Srivastava Soma2,Murinova Natalia3,Birlea Marius4,Ahmed Zubair5,Digre Kathleen6,Lopez Kristina7,Mullally William8,Blaya Maike Tiede9,Pippitt Karly10ORCID,Cutrer Fred Michael11,DeLange Justin12,Schecht Howard13,Rizzoli Paul8,Lane Judy14,Wald John15,Cortez Melissa M6,Martin Vincent T16,Spare Nicole M17,Hentz Joseph G1,Robert Teri18,Dodick David W1,

Affiliation:

1. Mayo Clinic, Department of Neurology, Phoenix, AZ, USA

2. University of Southern California, Department of Neurology, Los Angeles, CA, USA

3. University of Washington, Department of Neurology, Seattle, WA, USA

4. University of Colorado, Department of Neurology, Denver, CO, USA

5. Cleveland Clinic Foundation, Department of Neurology, Cleveland, OH, USA

6. University of Utah, Department of Neurology, Salt Lake City, UT, USA

7. West Virginia University, Department of Neurology, Morgantown, WV, USA

8. Brigham and Women’s Hospital, Department of Neurology, Boston, MA, USA

9. Memorial Healthcare, Department of Neurology, Hollywood, FL, USA

10. University of Utah, Department of Family and Preventive Medicine, Salt Lake City, UT, USA

11. Mayo Clinic, Department of Neurology, Rochester, MN, USA

12. Northern Arizona Healthcare, Department of Neurology, Flagstaff, AZ, USA

13. The Toledo Clinic, Department of Neurology, Toledo, OH, USA

14. Blue Sky Neurology, Department of Neurology, Denver, CO, USA

15. Henry Ford Allegiance, Department of Neurology, Jackson, MI, USA

16. University of Cincinnati, Department of Internal Medicine, Cincinnati, OH, USA

17. Thomas Jefferson University, Department of Neurology, Philadelphia, PA, USA

18. Patient advocate and educator, Washington, WV, USA

Abstract

Objective “Pain interference” and “headache impact” refer to negative consequences that pain and headache have on one’s life. This study investigated determinants of these negative impacts in a large patient cohort who have chronic migraine with medication overuse. Methods Six hundred and eleven adults were enrolled from 34 headache, neurology, and primary care clinics. Negative consequences of chronic migraine with medication overuse were determined using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference 6b questionnaire and the Headache Impact Test 6. Relationships between PROMIS-6b and Headache Impact Test 6 scores with demographics, headache characteristics, medication use, anxiety symptoms, and depression symptoms were assessed with linear regression. Elastic Net regression was used to develop a multiple regression model. Results PROMIS-6b T-Scores averaged 65.2 (SD 5.4) and Headache Impact Test 6 scores averaged 65.0 (SD 5.3), indicating severe negative consequences of chronic migraine with medication overuse. Chronic migraine with medication overuse interfered with enjoyment of life, concentration, daily activities, doing tasks away from home, and socializing. Depression symptom severity had the strongest relationship with pain interference and headache impact. Moderate-to-severe headache frequency, headache intensity, and anxiety symptoms were also associated with pain interference and headache impact. Conclusions Chronic migraine with medication overuse is associated with substantial negative consequences, the extent of which is most strongly related to depression symptoms.

Funder

Patient-Centered Outcomes Research Institute

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

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