Evaluation Of A Medication Dependence Questionnaire In Migraineurs Of The Chinese Version And Analysis On The Risk Factors Of Medication-overuse Headache Relapse

Objective:To evaluate the reliability and validity of a medication dependence questionnaire in migraine patients of the Chinese version. To assess whether the questionnaire can be used as a measurement tool for the evaluation of medication dependence in Chinese migraineurs.Methods:All the115migraine patients that has drug dependence syndrome were chosen from those who came to Shandong Provincial Hospital from February2013to February2014. The diagnosis of drug dependence syndrome was according to the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The migraine patients with other chronic pain diseases who have long-term use of analgesics or with other severe chronic diseases, with severe neurocognitive dysfunction or mental confusion were excluded. The clinical data of115patients were collected which include general information, medical history, physical examination and auxiliary examination. All the patients were interviewed face to face with the medication dependence questionnaire in migraine patients of the Chinese version and analysis the result of the questionnaire including reliability and validity. According to test-retest reliability and internal consistency reliability to evaluate reliability, and the content validity and construct validity to evaluate validity.Results:The test-retest reliability was0.725-1.000except item11(0.558) and iteml6(0.443). The internal consistency coefficient was0.820, all the dimensions internal consistency coefficients were above0.7. Every item scores were positively correlated with the corresponding dimension scores (r=0.595-0.962). Seven factors with latent roots greater than1which could explain76.3%of total variance, and the factor loads of seven common factors were relatively powerful in related item. Conclusions:The medication dependence questionnaire in migraine patients of the Chinese version shows preferable reliability and validity. It is a promising assessment tool to evaluate the medication dependence in Chinese migraine patients in future clinical practice. Objective:The purpose of this study was to analysis and evaluate the risk factors of the medication-overuse headache (MOH) relapse.Methods:86patients who were first diagnosed as MOH and had successful withdrawal treatment in two months were chosen from out-patient of Shandong Provincial Hospital from March2012to July2013. All the subjects were followed up by the authors. Of these subjects,27cases who had relapsed were compared with59controls who had not relapsed. Based on a standardized questionnaire, a database was made with Microsoft Office Excel2010. The data including38indexes were analyzed by univariate analysis with Chi-square test, Fisher’s exact test, t-test or paired rank test respectively. The statistically correlated variables (P<0.05) were chosen as the independent variable, then nonconditional multivariate stepwise logistic regression was made.Results:The independent risk factors of medication-overuse headache relapse were the number of headache days per month before withdrawal, duration of primary headache and the number of headache days per month after withdrawal.Conclusions:The number of headache days per month before withdrawal, duration of primary headache and number of headache days per month after withdrawal are the independent risk factors for MOH relapse.