Effectiveness of a multidisciplinary treatment program for chronic daily headache.
BACKGROUND
Chronic daily headache (CDH: headache on fifteen days a month or more) is one of the most common forms of chronic pain. The relative efficacy of different treatment methods for these patients needs to be determined.


OBJECTIVE
To compare treatment outcomes for patients with CDH treated in a traditional office-based pharmacological treatment program with a second group treated in a multidisciplinary management program.


METHODS
Patient outcomes were measured using changes in the Headache Disability Inventory (HDI) and the Short-Form-36 (SF-36) over the treatment period. Outcomes from seventy patients treated in an office setting were compared to thirty-seven patients treated in a multidisciplinary headache treatment program. Both groups received similar pharmacological treatment. All patients treated in the office setting and the majority of patients in the multidisciplinary program had transformed migraine.


RESULTS
Even though a reduction in headache days per month occurred, mean headache related disability (measured by HDI) and mean Health Related Quality of Life (HRQoL measured by SF-36) did not improve for the patient group treated in the office setting but did improve significantly for the patient group treated in the multidisciplinary headache program.


CONCLUSIONS
For patients with CDH, headache-related disability and HRQoL is more likely to improve with management in a multidisciplinary headache treatment program as compared to the traditional specialist consultation-family physician office-based setting.
Magnusson
Jane E
JE
Department of Clinical Neurosciences, University of Calgary and the Calgary Health Region, Calgary, Alberta, Canada.
Riess
Connie M
CM
Becker
Werner J
WJ
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D005260:Female; D020773:Headache Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome