The investigators will perform a cluster randomised controlled study of Brief intervention (BI) for medication-overuse headache (MOH) versus business as usual. GPs will be trained to perform a structured brief intervention after identifying patients with probable MOH using the severity of dependence scale. The control arm will include patients of GPs who have not been trained in BI. Patients will be recruited by prior short postal screening of patients listed on the GPs patient lists. The hypothesis is that BI will lead to improvement of medication-overuse and chronic headache as compared to no BI. Main outcomes are: * number of medication days per month * number of headache days per month * headache index
123 cases in all included (75 in intervention/placebo control arms and 48 in non-intervention Control arms) 19 did not meet predefined inclusion criteria for the different arms (5 and 8 in intervention arm and placebo arm respectively, 4 and 2 in chronic headache Control and population Control respectively) 1 case was lost to follow up in each of the 4 Groups prior to first assessment. Thus 60 cases remained in intervention/placebo Control arms (24 in intervention and 36 in placebo Control) and 40 in non intervention Control arms (15 chronic headache Controls, 25 population Controls).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
123
Structured behavioural Brief intervention given by trained GPs
GPs to treat patient as they have until now based on best established practice
No additional intervention
No additional intervention
Akershus University Hospital
Lørenskog, Norway
Dept of general medicine, University of Oslo
Oslo, Norway
Number of medication days per month
Time frame: 3 months
Number of headache days per month
Time frame: 3 months
Proportion significantly improved
proportion improved \>50% and \>25% in terms of no headache days/month
Time frame: 3 month
Headache medication days per month (diary reported)
Time frame: 3 months
Headache days/month (diary reported)
Time frame: 3 months
Average headache intensity (VAS)
Time frame: 3 months
Quality of life
Time frame: 3 months
Self-reported health related costs
Time frame: 3 months
Long term follow up of same outcomes as above plus relapse rate
Time frame: 12 months
Headache index
Headache intensity x frequency x duration
Time frame: 3 months
Follow up of same outcomes as for 3 months
Added extra time point due to cross over of non-treated patients into intervention Group if intervention was positive at 3 months.
Time frame: 6 months
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