November 14, 2018
High and low achievement motivation participants did not differ in the reduction of days with acute headache medication at 3 or 6 months.
A recent study in Headache advised against the premise that high achievement motivated patients suffering from migraines are more prone to use acute headache medication to be functional at work or in daily in life.
Researchers in this cross-sectional observational cohort study (conducted at a tertiary headache center in Germany) sought to determine whether high achievement motivated participants with migraines have a higher total intake of acute migraine medication, a higher propensity to take acute migraine medication, or more frequent diagnoses of medication overuse headache (MOH) in comparison with a referent group.
Participants maintained a standardized daily headache diary assessing headache intensity and use of medication. In addition, researchers used the Migraine Disability Assessment Scale (MIDAS) to measure the effects of migraine on daily life, the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression, and the Achievement Motivation Inventory Short Form (AMI-SF) to measure achievement motivation.
The study population was composed of 117 participants characterized by episodic migraine with aura (n=18), episodic migraine without aura (n=42), and chronic migraine (n=57).
The average AMI-SF score for the study population was 135.4±32.6 compared with the norm population’s average score of 141.5. There were no significant differences based on sex. The researchers used median split on AMI-SF scores to define high achievement motivation as 161.6±15.2 (n=56) and low achievement motivation as 108.1±22.9 (n=54).
At time of first presentation, 39 of the participants used migraine preventive medication such as beta-blockers (n=15), anti-depressants (n=10), and anti-convulsants (n=14).
Of the 117 participants, 30.8% fulfilled the criteria for MOH.
There were no significant differences observed in headache intensity, headache history, HADS scores, or MIDAS scores between high and low achievement motivated participants. Furthermore, high achievement motivated participants did not have more days per month with acute headache medication compared with low achievement motivation participants.
The data showed that more participants used acute headache medication as headache intensity increased. Participants indicated usage of medication when they expected a hard day at work (12.8%) or feared they wouldn’t be able to perform at work (15.4%).
The authors noted the potential patient bias, low study population, median split data analysis procedure limitation, lack of validation of the propensity assessment, and lack of generalizability as study limitations.
In conclusion, the results showed “no evidence for an effect of achievement motivation on the frequency of acute headache medication use.”
Sorgenfrei V, Kropp P, Straube A, Ruscheweyh R. High achievement motivation is not related to increased use of acute headache medication in migraine: a cross-sectional observational cohort study [published online October 27, 2018]. Headache. doi: 10.1111/head.13431