Multidisciplinary integrated headache care: a prospective 12-month follow-up observational study
Open Access
- 12 July 2012
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in The Journal of Headache and Pain
- Vol. 13 (7), 521-529
- https://doi.org/10.1007/s10194-012-0469-y
Abstract
This prospective study investigated the effectiveness of a three-tier modularized out- and inpatient multidisciplinary integrated headache care program. N = 204 patients with frequent headaches (63 migraine, 11 tension-type headache, 59 migraine + tension-type headache, 68 medication-overuse headache and 3 with other primary headaches) were enrolled. Outcome measures at baseline, 6- and 12-month follow-ups included headache frequency, Migraine Disability Assessment (MIDAS), Hospital Anxiety and Depression Scale (HADS), standardized headache diary and a medication survey. Mean reduction in headache frequency was 5.5 ± 8.5 days/month, p < 0.001 at 6 months’ follow-up and 6.9 ± 8.3 days/month, p < 0.001 after 1 year. MIDAS decreased from 53.0 ± 60.8 to 37.0 ± 52.4 points, p < 0.001 after 6 months and 34.4 ± 53.2 points, p < 0.001 at 1 year. 44.0 % patients demonstrated at baseline an increased HAD-score for anxiety and 16.7 % of patients revealed a HAD-score indicating a depression. At the end of treatment statistically significant changes could be observed for anxiety (p < 0.001) and depression (p < 0.006). The intake frequency of attack-aborting medication decreased from 10.3 ± 7.3 days/month at admission to 4.7 ± 4.1 days/month, p < 0.001 after 6 months and reached 3.8 ± 3.5 days/month, p < 0.001 after 1 year. At baseline 37.9 % of patients had experience with non-pharmacological treatments and 87.0 % at 12-month follow-up. In conclusion, an integrated headache care program was successfully established. Positive health-related outcomes could be obtained with a multidisciplinary out- and inpatient headache treatment program.Keywords
This publication has 50 references indexed in Scilit:
- Validation of criterion-based patient assignment and treatment effectiveness of a multidisciplinary modularized managed care program for headacheThe Journal of Headache and Pain, 2012
- Evaluating integrated headache care: a one-year follow-up observational study in patients treated at the Essen headache centreBMC Neurology, 2011
- A randomized controlled trial on medication-overuse headache: outcome after 1 and 4 yearsActa Neurologica Scandinavica, 2011
- Integrated headache careCephalalgia, 2011
- Epidemiology of medication overuse headache in the general Swedish populationCephalalgia, 2011
- Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational studyThe Journal of Headache and Pain, 2011
- Recommendations for headache service organisation and delivery in EuropeThe Journal of Headache and Pain, 2011
- Clinical features, pathophysiology, and treatment of medication-overuse headacheThe Lancet Neurology, 2010
- Risk factors in medication-overuse headache: A 1-year follow-up study (care II protocol)Cephalalgia, 2009
- Management of Medication Overuse Headache: 1-Year Randomized Multicentre Open-Label TrialCephalalgia, 2009