Multidisciplinary integrated headache care: a prospective 12-month follow-up observational study

The Journal of Headache and Pain

Original

Thomas-Martin Wallasch¹  Peter Kropp² 

[1] Headache Center Berlin at the Sankt Gertrauden Krankenhaus, Berlin, Germany;MEDAS Ostschweiz, Kornhausstr. 3, 9000, St Gallen, Switzerland;Medical Faculty of the University, Institute of Medical Psychology and Medical Sociology, Rostock, Germany;

关键词: Integrated;    Care;    Multidisciplinary treatment program;    Outcome study;    Headache-related disability;    Headache-related quality of life;    Chronic headache;   

DOI  :  10.1007/s10194-012-0469-y

 received in 2012-04-19, accepted in 2012-06-21,  发布年份 2012

来源: Springer

【 摘 要 】

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. In conclusion, an integrated headache care program was successfully established. Positive health-related outcomes could be obtained with a multidisciplinary out- and inpatient headache treatment program.

【 授权许可】

CC BY   
© The Author(s) 2012