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

作者：Wallasch Thomas Martin^*; Kropp Peter

来源：Journal of Headache and Pain, 2012, 13(7): 521-529.

DOI：10.1007/s10194-012-0469-y

• Integrated
• Care
• Multidisciplinary treatment program
• Outcome study
• Headache-related disability
• Headache-related quality of life
• Chronic headache

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 +/- A 8.5 days/month, p %26lt; 0.001 at 6 months%26apos; follow-up and 6.9 +/- A 8.3 days/month, p %26lt; 0.001 after 1 year. MIDAS decreased from 53.0 +/- A 60.8 to 37.0 +/- A 52.4 points, p %26lt; 0.001 after 6 months and 34.4 +/- A 53.2 points, p %26lt; 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 %26lt; 0.001) and depression (p %26lt; 0.006). The intake frequency of attack-aborting medication decreased from 10.3 +/- A 7.3 days/month at admission to 4.7 +/- A 4.1 days/month, p %26lt; 0.001 after 6 months and reached 3.8 +/- A 3.5 days/month, p %26lt; 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.

• 出版日期2012-10
• 单位河北医科大学