Outcomes of a headache-specific cross-sectional multidisciplinary treatment program

Headache. Jul-Aug 2012;52(7):1094-105. doi: 10.1111/j.1526-4610.2012.02189.x. Epub 2012 Jun 15.

Abstract

Aim: Chronic headache is a disabling disorder that is frequently poorly managed in general clinical practice.

Objectives: To investigate primary (headache frequency in days/month) and secondary (headache-related disability, lost work/school time, anxiety and depression, amount and intake frequency of acute medication) 12-month outcomes of a headache-specific cross-sectional outpatient and inpatient multidisciplinary treatment program using a dedicated computer system for data collection and corresponding between integrated care team in a tertiary headache center and practicing headache specialists.

Background: A need for integrated headache care using comprehensive and standardized assessment for diagnosis of headache, psychiatric comorbidity, and burden of disease exists. There are little published data on long-term efficacy of multidisciplinary treatment programs for chronic headache.

Design: A prospective, observational, 12-month, follow-up study.

Subjects and methods: Prospectively recruited consecutive patients with frequent difficult-to-treat headaches (n = 201; 63 migraine, 11 tension-type headache, 59 combined migraine/tension-type headache, and 68 medication overuse headache) were enrolled. Outcome measures included prospective headache diaries, a medication survey, Migraine Disability Assessment, 12-item short form health survey, and the Hospital Anxiety and Depression Scale.

Results: The primary outcome of a reduction of ≥50% of headache frequency (days/month) was observed in 62.7%. Mean headache frequency decreased from 14.4 ± 8.2 to 7.6 ± 8.3 days/month, P < .0001. Secondary outcomes improved significantly in the total cohort and all headache subgroups. Predictors for good outcome were younger age, few days lost at work/school, and familiarity with progressive muscle relaxation therapy at baseline.

Conclusions: The present analysis provided support for a cross-sectional multidisciplinary integrated headache-care program.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Cross-Sectional Studies
  • Delivery of Health Care, Integrated*
  • Depression / epidemiology
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Incidence
  • Inpatients
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Migraine Disorders / psychology
  • Migraine Disorders / therapy*
  • Outcome Assessment, Health Care*
  • Outpatients
  • Private Practice*
  • Prospective Studies
  • Tension-Type Headache / psychology
  • Tension-Type Headache / therapy*
  • Tertiary Care Centers*
  • Treatment Outcome