Medication-overuse headache hospitalisations in Australia, 2009–2024: A national study of a preventable condition

BackgroundTo examine national trends in medication-overuse headache (MOH) hospitalisation rates, length of hospital stays, and patient demographics in Australia in the context of evolving access to medications implicated in MOH.MethodsA retrospective analysis of national hospital admissions data from the Australian Institute of Health and Welfare (AIHW), focusing on cases with a principal diagnosis of MOH from 2009 to 2024. MOH hospitalisation rates per 100,000 population and length of hospital stay were analysed over time and stratified by age group and sex.ResultsA total of 2480 MOH cases were identified over 16 years, including 1661 (67%) females and 954 (38.5%) individuals aged > 60 years. Overall MOH-related hospitalisation rates declined (IRR: 0.97; 95% CI: 0.96-0.98), as did the average length of stay per admission (-0.035 days/year; p = 0.036). Females were more likely to be admitted (IRR: 1.95; 95% CI: 1.79-2.12), as were older patients (IRR: 8.08; 95% CI: 6.77-9.65); however, longer stays were observed only among older patients (mean [SD]: 2.74 [0.48] vs. 2.21 [0.37] days; p = 0.005).ConclusionThis trend, occurring alongside rising migraine-related hospitalisations, the phasing out of ergotamine, and increased triptan use, may be partially attributed to the 2018 codeine rescheduling. Future studies using detailed prescription data are warranted to assess the long-term impact of medication policy changes on MOH trends.