The impact of intensive patient education on clinical outcome in a clinic-based migraine population.
OBJECTIVE
To determine whether the addition of patient education to routine medical management improves the clinical status of migraine patients and reduces their utilization of healthcare resources.


BACKGROUND
Optimal migraine management typically requires effective patient education. Such education often is difficult to accomplish in the busy clinic setting.


METHODS
One hundred consecutive patients with migraine presenting to an university-based headache clinic were randomized to receive or not receive a standardized course of didactic instruction regarding migraine biogenesis and management. The course consisted of 3 classes taught by lay migraineurs who themselves previously had undergone intensive training. All patients were evaluated initially and at 1, 3, and 6 months by a neurologist blinded as to the results of randomization. Clinical variables examined included headache frequency/severity, migraine disability assessment (MIDAS) scores, patient compliance, presence versus absence of analgesic use/overuse, and headache-related unscheduled visits or phone calls. Comparisons were made between baseline findings and findings at the 6-month follow-up visit, with the change in mean MIDAS score serving as the primary outcome variable.


RESULTS
At 6 months the group randomized to receive intensive education exhibited a significantly greater reduction in mean MIDAS score than the group randomized to routine medical management only (24 vs. 14 points; P < .05). Those patients also experienced a reduction in mean headache days per month and a greater reduction in functionally incapacitating headache days per month, exhibited less analgesic overuse and need for abortive therapy, were more compliant with prophylactic therapy prescribed, and made fewer headache-related calls to the clinic or unscheduled visits.


CONCLUSIONS
Intensive education of migraine patients by trained lay instructors may convey significant benefit to those patients and reduce their utilization of healthcare resources.
Rothrock
John Farr
JF
Department of Neurology, University of South Alabama, Mobile 36693, USA.
Parada
Victoria A
VA
Sims
Cheryl
C
Key
Kristin
K
Walters
Naomi S
NS
Zweifler
Richard M
RM
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology* / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010379:Peer Group; D016896:Treatment Outcome
D000700:Analgesics