Page 55 - The clinical aspects and management of chronic migraine Judith Anne Pijpers

Support by a headache nurse during withdrawal
patients visiting the outpatient headache clinic raised in the last two years of the inclusion period, the proportion of patients who met inclusion criteria remained the same (19.0% in group A and 20.6% in group B). To detect shifts in population composition due to exclusion of patients, lost to follow-up or missing data, differences between the total included population (n=416) and the population that had successfully withdrawn (n=267) were explored. No major differences in composition occurred.
Figure 1. Study population flowchart
3
MOH: Medication Overuse Headache; TTH: Tension-Type Headache; LUMC: Leiden University Medical Centre.
1 New outpatients: New patients at the LUMC outpatient headache clinic
2 Excluded: No medication overuse (2a n=645 2b n=893); Age < 18 years (2a n=1 2b n=3);
No withdrawal therapy (2a n=21 2b n=35); Withdrawal therapy elsewhere (2a n=27 2b n=45)
3Diagnosis MOH and advice is to withdraw medication: 3a without support by a headache nurse; 3b with support by a headache nurse
4Excluded: Patient is not willing to start withdrawal (4a n=5 4b n=13); Unsuccessful withdrawal (4a n=15 4b n=24); Lost to follow-up (4a n=44 4b n=31)
5Successful withdrawal: 2-3 months medication- and caffeine-free period.
6Excluded: No migraine, TTH or combination (6a n=1 6b n=2); Missing data on primary headache, number of headache days or caffeine use (6a n=5 6b n=9)
53