The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 15 Supplement 1

Abstracts from the 4th European Headache and Migraine Trust International Congress: EHMTIC 2014

Open Access

EHMTI-0056. Self-medication of headache: identification of subgroups of patients through cluster analysis

  • E Mehuys1,
  • K Paemeleire2,
  • G Crombez3,
  • T Van Hees4,
  • T Christiaens5,
  • L Van Bortel6,
  • I Van Tongelen1,
  • JP Remon1 and
  • K Boussery1
The Journal of Headache and Pain201415(Suppl 1):D46

Published: 18 September 2014


MigraineHierarchical Cluster AnalysisPain MedicationCommunity PharmacyMedication Overuse


We have previously shown that medication overuse is prevalent among individuals self-medicating regular headache.


In this study we evaluated self-medicating headache patients from a broader perspective, exploring the interplay between headache and concomitant pain conditions, pain-related disability and pain medication use. Identification of subgroups of patients could be helpful to tailor intervention strategies.


A hierarchical cluster analysis was used to group 1021 self-medicating headache patients according to their (1) sociodemographics, (2) pain characteristics, (3) pain-related disability and (4) pain medication use. Patients were recruited in 202 Belgian community pharmacies and fulfilled the following inclusion criteria: aged ≥18 years, purchasing an over-the-counter systemic analgesic, experiencing pain ≥1 full day/month and suffering from headache.


Three subgroups were identified. Group 1 comprised patients with low socioeconomic status, low self-rated health, on average four concomitant pain conditions, high pain frequency, high disability, and high rates of medication overuse. Group 2 included older patients with a mean of two other pain syndromes, and low disability but high pain intensity. Group 3 comprised young highly-educated patients diagnosed with migraine, having on average one concomitant pain condition, low pain frequency, low disability but high pain intensity, and low rates of medication overuse.


We have identified three subgroups in a large sample of individuals self-medicating headache. The marked differences across the three groups stress the importance of a holistic assessment of headache patients and the need for tailored strategies to reduce the risk of medication-overuse headache in primary care.

No conflict of interest.

Authors’ Affiliations

Pharmaceutical Care Unit, Ghent University, Ghent, Belgium
Department of Neurology, University Hospital Ghent, Ghent, Belgium
Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
Department of Clinical Pharmacy, University of Liège, Liège, Belgium
Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium


© Mehuys et al; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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