Top

Published in:

Open Access 01-08-2011 | Original

Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study

Authors: Charly Gaul, Christina van Doorn, Nadine Webering, Martha Dlugaj, Zaza Katsarava, Hans-Christoph Diener, Günther Fritsche

Published in: The Journal of Headache and Pain | Issue 4/2011

Abstract

This study investigated the outcome of a 5-day headache-specific multidisciplinary treatment program (MTP) and the adherence to treatment recommendations in 295 prospectively recruited consecutive headache patients [210 migraine, 17 tension-type headache (TTH), 68 combination headache, including 56 medication-overuse headache (MOH)]. Headache frequency decreased from 13.4 (±8.8) to 8.8 (±8.0) days per month after 12–18 months. Forty-three percent of the participants fulfilled the primary outcome (reduction of headache frequency of ≥50%), which was less likely in patients with combination of migraine and TTH compared to migraine (OR = 3.136, p = 0.002) or TTH (OR = 1.029, n.s.). Increasing number of headache days per month (OR = 1.092, p ≤ 0.0001) and adherence to lifestyle modifications (OR = 1.269, p = 0.004) predicted primary outcome. 51 of 56 MOH patients were treated successfully. Thirty-five percent of the patients were adherent to pharmacological prophylaxis, 61% to relaxation therapy, and 72% to aerobic endurance sports. MTP is effective in headache treatment. Adherence to therapy was associated with better outcome.

Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A et al (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27:193–210, 17381554, 10.1111/j.1468-2982.2007.01288.xCrossRefPubMed

Clouse JC, Osterhaus JT (1994) Healthcare resource use and costs associated with migraine in a managed healthcare setting. Ann Pharmacother 28:659–664, 8069007, 1:STN:280:DyaK2czkvVWltQ%3D%3DPubMed

Headache Classification Subcommittee of the International Headache Society (2004) The international classification of headache disorders: 2nd edition. Cephalalgia 24(Suppl 1):9–160

Martin VT (2009) Medication overuse and chronic migraine. Curr Pain Headache Rep 13:337–339, 19728958, 10.1007/s11916-009-0068-zCrossRefPubMed

Saper JR, Lake AE 3rd, Madden SF, Kreeger C (1999) Comprehensive/tertiary care for headache: a 6-month outcome study. Headache 39:249–263, 15613222, 10.1046/j.1526-4610.1999.3904249.x, 1:STN:280:DC%2BD2cnjslCqsw%3D%3DCrossRefPubMed

Evers S, Marziniak M (2010) Clinical features, pathophysiology, and treatment of medication-overuse headache. Lancet Neurol 9:391–401, 20298963, 10.1016/S1474-4422(10)70008-9CrossRefPubMed

Katsarava Z, Holle D, Diener HC (2009) Medication overuse headache. Curr Neurol Neurosci Rep 9:115–119, 19268034, 10.1007/s11910-009-0019-4CrossRefPubMed

Katsarava Z, Muessig M, Dzagnidze A, Fritsche G, Diener HC, Limmroth V (2005) Medication overuse headache: rates and predictors for relapse in a 4-year prospective study. Cephalalgia 25:12–15, 15606564, 10.1111/j.1468-2982.2004.00789.x, 1:STN:280:DC%2BD2cnjtFCrtA%3D%3DCrossRefPubMed

Jensen R, Zeeberg P, Dehlendorff C, Olesen J (2010) Predictors of outcome of the treatment programme in a multidisciplinary headache centre. Cephalalgia 30:1214–1224, 20855367, 10.1177/0333102410361403CrossRefPubMed

10.

Matchar DB, Harpole L, Samsa GP, Jurgelski A, Lipton RB, Silberstein SD et al (2008) The headache management trial: a randomized study of coordinated care. Headache 48:1294–1310, 18547268, 10.1111/j.1526-4610.2007.01148.xCrossRefPubMed

11.

Rains JC, Penzien DB, Lipchik GL (2006) Behavioral facilitation of medical treatment for headache—part I: Review of headache treatment compliance. Headache 46:1387–1394, 17040335, 10.1111/j.1526-4610.2006.00581.xCrossRefPubMed

12.

Linde M, Jonnson P, Hedenrud T (2008) Influence of disease features on adherence to prophylactic migraine medication. Acta Neurol Scand 118:367–372, 18513346, 10.1111/j.1600-0404.2008.01042.x, 1:STN:280:DC%2BD1cjkvVehsQ%3D%3DCrossRefPubMed

13.

Harpole LH, Samsa GP, Jurgelski AE, Shipley JL, Bernstein A, Matchar DB (2003) Headache management program improves outcome for chronic headache. Headache 43:715–724, 12890125, 10.1046/j.1526-4610.2003.03128.xCrossRefPubMed

14.

Silberstein S, Tfelt-Hansen P, Dodick DW, Limmroth V, Lipton RB, Pascual J et al for the Task Force of the International Headache Society Clinical Trials Subcommittee (2008) Guidelines for controlled trials of prophylactic treatment of chronic migraine in adults. Cephalalgia 28:484–495

15.

Zeeberg P, Olesen J, Jensen R (2005) Efficacy of multidisciplinary treatment in a tertiary referral headache centre. Cephalalgia 25:1159–1167, 16305604, 10.1111/j.1468-2982.2005.00980.x, 1:STN:280:DC%2BD2MnisFartg%3D%3DCrossRefPubMed

16.

Lang E, Kastner S, Neundörfer B, Bickel A (2001) Effects of recommendations and patient seminars on effectivity of outpatient treatment for headache. Schmerz 15:229–240, 11810361, 10.1007/s004820100053, 1:STN:280:DC%2BD38%2FotFejuw%3D%3DCrossRefPubMed

17.

Gunreben-Stempfle B, Griessinger N, Lang E, Muehlhans B, Sittl R, Ulrich K (2009) Effectiveness of an intensive multidisciplinary headache treatment program. Headache 49:990–1000, 19473281, 10.1111/j.1526-4610.2009.01448.xCrossRefPubMed

18.

Magnusson JE, Riess CM, Becker WJ (2004) Effectiveness of a multidisciplinary treatment program for chronic daily headache. Can J Neurol Sci 31:72–79, 15038474CrossRefPubMed

19.

Bigal ME, Rapoport AM, Sheftell FD, Tepper SJ, Lipton RB (2004) Transformed migraine and medication overuse in a tertiary headache centre—clinical characteristics and treatment outcomes. Cephalalgia 24:483–490, 15154858, 10.1111/j.1468-2982.2004.00691.x, 1:STN:280:DC%2BD2czhs12isw%3D%3DCrossRefPubMed

20.

Fritsche G, Frettlöh J, Hüppe M, Dlugaj M, Matatko N, Gaul C et al (2010) Prevention of medication overuse in patients with migraine. Pain 151:404–413, 20800968, 10.1016/j.pain.2010.07.032CrossRefPubMed

21.

Mongini F, Ciccone G, Rota E, Ferrero L, Ugolini A, Evangelista A et al (2008) Effectiveness of an educational and physical programme in reducing headache, neck and shoulder pain: a workplace controlled trial. Cephalalgia 28:541–552, 18318746, 10.1111/j.1468-2982.2008.01551.x, 1:STN:280:DC%2BD1c3jvFCrtA%3D%3DCrossRefPubMed

22.

Holroyd KA, Penzien DB (1990) Pharmacological versus non-pharmacological prophylaxis of recurrent migraine headache: a meta-analytic review of clinical trials. Pain 42:1–13, 2146583, 10.1016/0304-3959(90)91085-W, 1:STN:280:DyaK3M%2FksVCntQ%3D%3DCrossRefPubMed

23.

Penzien DB, Rains JC, Andrasik F (2002) Behavioral management of recurrent headache: three decades of experience and empiricism. Appl Psychophysiol Biofeedback 27:163–181, 12206049, 10.1023/A:1016247811416CrossRefPubMed

24.

Busch V, Gaul C (2008) Exercise in migraine therapy—is there any evidence for efficacy? A critical review. Headache 48:890–899, 18572431, 10.1111/j.1526-4610.2007.01045.xCrossRefPubMed

25.

Sjögren T, Nissinen KJ, Järvenpää SK, Ojanen MT, Vanharanta H, Mälkiä EA (2005) Effects of a workplace physical exercise intervention on the intensity of headache and neck and shoulder symptoms and upper extremity muscular strength of office workers: a cluster randomized controlled cross-over trial. Pain 116:119–128, 15927388, 10.1016/j.pain.2005.03.031CrossRefPubMed

26.

Gaul C, Eismann R, Schmidt T, May A, Leinisch E, Wieser T et al (2009) Use of complementary and alternative medicine in patients suffering from primary headache disorders. Cephalalgia 29:1069–1078, 19366356, 10.1111/j.1468-2982.2009.01841.x, 1:STN:280:DC%2BD1MngsV2ksQ%3D%3DCrossRefPubMed

27.

Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X (2008) Intervention for enhancing medication adherence. Cochrane Database Syst Rev (2):CD000011

28.

Grande RB, Aaseth K, Benth JS, Lundqvist C, Russell MB (2010) Reduction in medication-overuse headache after short information. The Akershus study of chronic headache. Eur J Neurol 18:129–137, 10.1111/j.1468-1331.2010.03094.xCrossRef

29.

Boe MG, Salvesen R, Mygland A (2009) Chronic daily headache with medication overuse: a randomized follow-up by neurologist or PCP. Cephalalgia 29:855–863, 19228151, 10.1111/j.1468-2982.2008.01810.x, 1:STN:280:DC%2BD1Mvos1Sktg%3D%3DCrossRefPubMed

Title: Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study
Authors: Charly Gaul
Christina van Doorn
Nadine Webering
Martha Dlugaj
Zaza Katsarava
Hans-Christoph Diener
Günther Fritsche
Publication date: 01-08-2011
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 4/2011
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1007/s10194-011-0348-y

At a glance: The STEP trials

Springer Medicine

Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2011

Familial neuralgia of occipital and intermedius nerves in a Chinese family

Migraine and restless legs syndrome: is there an association?

Recommendations for headache service organisation and delivery in Europe

A transient third cranial nerve palsy as presenting sign of spontaneous intracranial hypotension

Triptans attenuate capsaicin-induced CREB phosphorylation within the trigeminal nucleus caudalis: a mechanism to prevent central sensitization?

Botulinum toxin type-A in the prophylactic treatment of medication-overuse headache: a multicenter, double-blind, randomized, placebo-controlled, parallel group study