Multidisciplinary integrated headache care: a prospective 12-month follow-up observational study
The Journal of Headache and Pain, 07/18/2012
Wallasch TM et al. – An integrated headache care program was successfully established. Positive health–related outcomes could be obtained with a multidisciplinary out– and inpatient headache treatment program.
Methods- 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.
