Epidemiology

​The Global Burden of Disease study conducted in 2015 estimated that around 59 million people worldwide suffered from MOH.[7]​ Epidemiological data suggest that the prevalence of MOH in the general adult population ranges from 0.5% to 2.6%.[8]​ Peak prevalence of MOH occurs in the 50-60 years age group.[9]​ Data for children and adolescents are limited, although schools-based studies in African and Asian nations found that prevalence increases from childhood (mean 0.4%) to adolescence (mean 1.2%).[10]​ It is estimated that approximately one third of chronic migraine patients experience MOH, and this prevalence can be even higher in specialised healthcare centres.[11][12][13][14]​​​​​​​​​

The Nord-Trøndelag Health Survey (HUNT), an 11-year longitudinal population-based cohort study conducted in Norway, found an incidence rate for MOH of 0.72 cases per 1000 person-years.[4]​​ It identified female sex, anxiety or depression, low educational level, migraine as the pre-existing headache type, and use of sedatives as risk factors for developing MOH.[4] Cross-sectional studies provide further evidence that MOH is more common among females, and individuals with lower education and income levels.[15][16]​​​​

Among migraine patients, acute headache medication overuse is associated with factors including increasing age, smoking, presence of psychological symptoms, scalp allodynia, migraine symptom severity, and higher headache intensity.[2] Triptans are the most commonly overused drugs, followed by opioids and barbiturates, while MOH is less frequent among non-steroidal anti-inflammatory drug (NSAID) users.[2] Furthermore, conditions such as depression, anxiety, or chronic musculoskeletal disorders may contribute to medication overuse.[4]

MOH imposes a significant healthcare burden and incurs substantial costs, primarily due to lost productivity and frequent use of healthcare resources among those affected.[9][10]

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