Coping and Motivation for Change—An Interview Study of the Experience From Participation in an Educational Program for Patients With Medication-Overuse Headache

Patient educational programs (PEP) are recommended as part of the treatment for medication-overuse headache (MOH), however, knowledge of patients’ experiences when participating is sparse. This study explored how patients experienced participating in a PEP focusing on empowering coping strategies and motivation for behavioral changes. Eight individual semistructured interviews were conducted among patients suffering from MOH who had attended a PEP intervention in a randomized controlled trial. The PEP involved techniques from Motivational Interviewing as its communicative approach. Data collection, analysis, and interpretation were performed within a phenomenological-hermeneutic framework. Results showed that patients found the educational program relevant regarding coping with headache. Participants shifted from focusing on medication to include other ways to manage headache. Experiences regarding ambivalent feelings for behavioral change and feelings of stigmatization were key issues. Participation in this PEP helped the participants cope with headache in new ways relevant to their everyday lives and challenges. The individualized approach enabled by Motivational Interviewing was experienced as useful by the participants, as it actively involved them in the treatment.

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A randomized trial of telephone-based motivational interviewing for adolescent chronic headache with medication overuse

Cephalalgia ◽

10.1177/0333102413515336 ◽

2013 ◽

Vol 34 (6) ◽

pp. 446-454 ◽

Cited By ~ 17

Author(s):

Jack Stevens ◽

John Hayes ◽

Ann Pakalnis

Keyword(s):

Motivational Interviewing ◽

Medication Overuse ◽

Controlled Trial ◽

Medication Overuse Headache ◽

Standard Of Care ◽

Tension Type Headache ◽

Headache Frequency ◽

Care Clinic ◽

Headache Severity ◽

Phone Calls

Introduction Nearly 2% of youths suffer from chronic migraine or chronic tension-type headache (CTTH). A contributing factor in approximately 20%–50% of these youths is medication overuse, which involves taking analgesics three or more times per week for three months. The objective of this study was to test motivational interviewing (MI) as an approach to promote adherence to recommendations regarding not only analgesic overuse but also other aspects of treatment plans. Methods A randomized controlled trial was conducted comparing the experimental condition (standard of care clinic-based treatment with supplemental MI phone calls; n = 24) to a control condition (standard of care clinic-based treatment without these supplemental MI phone calls; n = 23). Four months after enrollment, a research assistant who was blinded to study condition telephoned adolescents inquiring about headache frequency, headache severity, and disability. Results Headache frequency was lower in the experimental condition versus control condition for those with relatively lower initial levels of headache frequency. In contrast, we did not find greater improvement in headache severity and disability for the experimental condition relative to the control condition. Discussion Our findings provided some preliminary, albeit limited, support for MI as an approach to improve outcomes for adolescent medication-overuse headache (MOH).

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Dependence‐like behaviour in patients treated for medication overuse headache: A prospective open‐label randomized controlled trial

European Journal of Pain ◽

10.1002/ejp.1715 ◽

2020 ◽

Author(s):

C Rouw ◽

SB Munksgaard ◽

IMS Engelstoft ◽

M Nielsen ◽

ML Westergaard ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Medication Overuse ◽

Controlled Trial ◽

Medication Overuse Headache ◽

Open Label ◽

Randomized Controlled

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Medication‐overuse headache: The effect of a patient educational programme—A randomized controlled trial

European Journal of Pain ◽

10.1002/ejp.1500 ◽

2019 ◽

Vol 24 (2) ◽

pp. 435-447 ◽

Cited By ~ 1

Author(s):

Louise S. Mose ◽

Susanne S. Pedersen ◽

Rigmor H. Jensen ◽

Bibi Gram

Keyword(s):

Randomized Controlled Trial ◽

Medication Overuse ◽

Controlled Trial ◽

Medication Overuse Headache ◽

Educational Programme ◽

Randomized Controlled

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Validity of self-reported assessment of Severity of Dependence Scale in Medication-Overuse Headache

Scandinavian Journal of Pain ◽

10.1515/sjpain-2019-0022 ◽

2019 ◽

Vol 19 (4) ◽

pp. 837-841 ◽

Cited By ~ 1

Author(s):

Espen Saxhaug Kristoffersen ◽

Jūratė Šaltytė Benth ◽

Jørund Straand ◽

Michael Bjørn Russell ◽

Christofer Lundqvist

Keyword(s):

Medication Overuse ◽

Controlled Trial ◽

Medication Overuse Headache ◽

Self Assessment ◽

Web Based ◽

Withdrawal Therapy ◽

Dependence Scale ◽

Self Administered Questionnaire ◽

Population Controls ◽

Severity Of Dependence Scale

Abstract The interview-based Severity of Dependence Scale (SDS) predicts the outcome of withdrawal therapy in Medication-Overuse Headache (MOH). We aimed to compare the interview-based SDS with a self-administrated written version. Fifty-three MOH patients, 19 chronic headache patients without medication overuse and 25 population controls were recruited from a previous randomized controlled trial. The SDS was scored in a telephone interview by headache experts, further, the participants filled in the SDS as a part of a self-administered questionnaire. The SDS assesses scores dependence through five questions, each scored from 0 to 3. A score of ≥5 is associated with MOH. Mean SDS scores were 2.8 (SD 3.0) vs. 3.1 (SD 2.9), p = 0.12, for the interview vs. the self-reported questionnaire, with a correlation 0.78. There was a non-significant bias of 0.32 (95% limits of agreement of −3.6; 4.2) between the two methods in the Bland-Altman analysis. A self-reported SDS questionnaire can be used, and may yield valuable information as a screening tool prior to headache consultations or studies. The possibilities of designing web-based self-treatment tools based on SDS self-assessment and brief intervention may be a future approach for a large group of patients.

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