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

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

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1
Headache Center Berlin, Sankt Gertrauden Krankenhaus Berlin, Germany. tomwallasch@aol.com

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.

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