A Flexible Format Interdisciplinary Treatment and Rehabilitation Program for Chronic Daily Headache: Patient Clinical Features, Resource Utilization and Outcomes

作者：Barton Pamela M^*; Schultz Geoffrey R; Jarrell John F; Becker Werner J

来源：Headache, 2014, 54(8): 1320-1336.

DOI：10.1111/head.12376

• chronic pain
• pain clinics
• headache
• multidisciplinary
• health services needs and demands

Objective.-To describe the demographics, diagnoses, program duration, human resource utilization and outcomes of patients with chronic daily headache treated in an ambulatory, interdisciplinary, flexible format, treatment and rehabilitation program. %26lt;br%26gt;Background.-Research indicates that multidisciplinary care is an effective approach to manage chronic daily headache, but little is known about the resources needed for effective care. %26lt;br%26gt;Methods.-The study was a secondary data analysis within a cohort design of previously collected data. Patients completed questionnaires and outcome measures on admission and discharge. Diagnoses were extracted from patient charts by professional health records personnel. A central scheduling database provided patient-specific clinician care hours by discipline and type (direct, indirect, group) as well as overall program duration. %26lt;br%26gt;Results.-One hundred and eighteen patients were studied (mean age 41.1 +/- 10.4 [(x) over bar +/- SD], 80% female). Sixty-two patients (52.5%) completed the program (%26quot;completers%26quot;). Migraine was the most common diagnosis. Thirty-six percent of patients had medication overuse. Average pain, mood, disability, and quality of life were significantly improved in completers (P %26lt; .001). They utilized 76 +/- 45.1 (%26lt;(x)over bar%26gt; +/- SD) total hours of care delivered over a mean of 129.7 +/- 66.1 weeks. %26lt;br%26gt;Conclusion.-Our study provides evidence that ambulatory, interdisciplinary, flexible format, treatment and rehabilitation programs are effective in the treatment of chronic daily headache, and we provide data on the resources used by our program in the treatment and rehabilitation of these patients.

• 出版日期2014-9