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Outcomes of a Headache‐Specific Cross‐Sectional Multidisciplinary Treatment Program

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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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Document Type: Research Article

Affiliations: 1: From the Headache Center Berlin at the Sankt Gertrauden Krankenhaus Berlin, Germany (T.-M. Wallasch); MEDAS Ostschweiz, St. Gallen, Switzerland (T.-M. Wallasch); Medical Faculty of the University, Institute of Medical Psychology and Medical Sociology, Rostock, Germany (A. Angeli and P. Kropp). 2: From the Headache Center Berlin at the Sankt Gertrauden Krankenhaus Berlin, Germany (T.-M. Wallasch); MEDAS Ostschweiz, St. Gallen, Switzerland (T.-M. Wallasch); Medical Faculty of the University, Institute of Medical Psychology and Medical Sociology, Rostock, Germany (A. Angeli and P. Kropp). 3: From the Headache Center Berlin at the Sankt Gertrauden Krankenhaus Berlin, Germany (T.-M. Wallasch); MEDAS Ostschweiz, St. Gallen, Switzerland (T.-M. Wallasch); Medical Faculty of the University, Institute of Medical Psychology and Medical Sociology, Rostock, Germany (A. Angeli and P. Kropp).

Publication date: July 1, 2012

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