The impact of intensive patient education on clinical outcome in a clinic-based migraine population

Headache. 2006 May;46(5):726-31. doi: 10.1111/j.1526-4610.2006.00428.x.

Abstract

Objective: To determine whether the addition of patient education to routine medical management improves the clinical status of migraine patients and reduces their utilization of healthcare resources.

Background: Optimal migraine management typically requires effective patient education. Such education often is difficult to accomplish in the busy clinic setting.

Methods: One hundred consecutive patients with migraine presenting to an university-based headache clinic were randomized to receive or not receive a standardized course of didactic instruction regarding migraine biogenesis and management. The course consisted of 3 classes taught by lay migraineurs who themselves previously had undergone intensive training. All patients were evaluated initially and at 1, 3, and 6 months by a neurologist blinded as to the results of randomization. Clinical variables examined included headache frequency/severity, migraine disability assessment (MIDAS) scores, patient compliance, presence versus absence of analgesic use/overuse, and headache-related unscheduled visits or phone calls. Comparisons were made between baseline findings and findings at the 6-month follow-up visit, with the change in mean MIDAS score serving as the primary outcome variable.

Results: At 6 months the group randomized to receive intensive education exhibited a significantly greater reduction in mean MIDAS score than the group randomized to routine medical management only (24 vs. 14 points; P < .05). Those patients also experienced a reduction in mean headache days per month and a greater reduction in functionally incapacitating headache days per month, exhibited less analgesic overuse and need for abortive therapy, were more compliant with prophylactic therapy prescribed, and made fewer headache-related calls to the clinic or unscheduled visits.

Conclusion: Intensive education of migraine patients by trained lay instructors may convey significant benefit to those patients and reduce their utilization of healthcare resources.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities / statistics & numerical data
  • Analgesics / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / psychology*
  • Migraine Disorders / therapy*
  • Patient Compliance
  • Patient Education as Topic / methods*
  • Peer Group*
  • Treatment Outcome

Substances

  • Analgesics