Quality standard

Quality statement 2: Preventing medication overuse headache

Quality statement

People with a primary headache disorder are given information on the risk of medication overuse headache.

Rationale

Medication overuse is a cause of secondary headaches in people with a primary headache disorder. Providing information to people with a primary headache disorder about the risk of medication overuse may prevent these secondary headaches.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that people with a primary headache disorder are given information on the risk of medication overuse headache.

Data source: Local data collection.

Process

Proportion of people with a primary headache disorder who are given information on the risk of medication overuse headache.

Numerator – the number of people in the denominator who are given information on the risk of medication overuse headache.

Denominator – the number of people with a primary headache disorder.

Data source: Local data collection.

Outcome

Incidence of medication overuse headache.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for people with a primary headache disorder to be given information on the risk of medication overuse headache.

Healthcare practitioners, including pharmacists, give people with a primary headache disorder information on the risk of medication overuse headache.

Commissioners ensure that they commission services that give people with a primary headache disorder information on the risk of medication overuse headache.

People with a headache disorder with no known cause are given information about the risk of too much medication causing more headaches.

Source guidance

Headaches in over 12s: diagnosis and management. NICE guideline CG150 (2012, updated 2021), recommendation 1.3.6

Definitions of terms used in this quality statement

Primary headache disorders

These include tension-type headache, migraine and cluster headache, as defined in the headache features table (see the NICE guideline on headaches in over 12s) and which have been diagnosed as a result of excluding other causes and taking a history.

Medication overuse headaches

These are headaches associated with taking too much medication. They most commonly occur in people taking medication for a primary headache disorder, especially for tension-type headaches and migraine.

Equality and diversity considerations

All information given about the risk of medication overuse headache should be culturally appropriate and accessible to people with additional needs, such as physical, sensory or learning disabilities, and to people who do not speak or read English. People with a primary headache disorder should have access to an interpreter or advocate if needed.

It may be appropriate in some cases, particularly with young people, to provide information to parents and carers as well as the person with the headache disorder.