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Background/Aim: Headache disorders, such as tension type headache or migraine, belong to the most prevalent diseases worldwide and have a high disease burden. Treatment usually consists of acute medication like non-opioid analgesics which are often available as over-the-counter medication (OTC). To date, there are few data on how German headache patients consume analgesics and none regarding medication beliefs, which can be important for treatment because compliance and addiction partly depend on how patients feel about medication. While problematic medication use can be assessed by a German short questionnaire for medication use (“Kurzfragebogen für Medikamentengebrauch”; KFM), medication beliefs can be displayed by the Beliefs about Medicines Questionnaire (BMQ).

Therefore, the aim of this study was examining how analgesic use differs among respondents with headache compared with those without headache, and whether medication-related thinking differs between the two groups.

Methods: This retrospective descriptive study utilizes data from the 2021 Epidemiological Survey of Substance Abuse, a German cross-sectional population-based study. Respondents with and without headache were compared in terms of demographic variables and medication use, prescriptions and OTC use in two different time intervals. We compared beliefs about medication and problematic medication use, considering a 12-month time frame, determined by the BMQ and the KFM.

Results: Out of 9,046 respondents, 1,049 respondents reported suffering from headache (11.9%). In all age groups, women were more often affected than men (17.8% of female respondents vs. 6.0% of male respondents). Respondents with headache significantly more often reported analgesic use than respondents without headache (93.5% vs. 69% in a 12-month interval). Most respondents with headache and respondents without headache used at least one OTC (71.2% vs. 52.2%), many of them used only OTC drugs (37.3% vs. 36.2%). A larger proportion of respondents with headache tended to see benefits of medication rather than risks (37.8% vs. 22.8%). However, they significantly more often showed problematic medication use, measured by the KFM, compared to those without headache (26% vs. 5.2%).

Discussion/Conclusion: Most headache patients consumed analgesics, and they perceived a higher need for these. OTC use is common, which means accessibility for medication, but also less surveillance of side effects and the number of analgesics consumed. Our results indicate that further treatment and prophylactic options are needed and that knowledge about these should be spread. Further studies are needed to explore if effects are based on comorbidities or headache itself.