title: Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study.
abstract: This study investigated the outcome of a 5-day headache-specific multidisciplinary treatment program (MTP) and the adherence to treatment recommendations in 295 prospectively recruited consecutive headache patients [210 migraine, 17 tension-type headache (TTH), 68 combination headache, including 56 medication-overuse headache (MOH)]. Headache frequency decreased from 13.4 (±8.8) to 8.8 (±8.0) days per month after 12-18 months. Forty-three percent of the participants fulfilled the primary outcome (reduction of headache frequency of ≥50%), which was less likely in patients with combination of migraine and TTH compared to migraine (OR = 3.136, p = 0.002) or TTH (OR = 1.029, n.s.). Increasing number of headache days per month (OR = 1.092, p ≤ 0.0001) and adherence to lifestyle modifications (OR = 1.269, p = 0.004) predicted primary outcome. 51 of 56 MOH patients were treated successfully. Thirty-five percent of the patients were adherent to pharmacological prophylaxis, 61% to relaxation therapy, and 72% to aerobic endurance sports. MTP is effective in headache treatment. Adherence to therapy was associated with better outcome.
authors.affiliation: Headache Center, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany. charly.gaul@gmx.de
authors.forename: Charly
authors.initials: C
authors.lastname: Gaul
authors.forename: Christina
authors.initials: C
authors.lastname: van Doorn
authors.forename: Nadine
authors.initials: N
authors.lastname: Webering
authors.forename: Martha
authors.initials: M
authors.lastname: Dlugaj
authors.forename: Zaza
authors.initials: Z
authors.lastname: Katsarava
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.forename: Günther
authors.initials: G
authors.lastname: Fritsche
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006261:Headache / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics / Q000458:organization & administration; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012064:Relaxation Therapy; D016896:Treatment Outcome; D055815:Young Adult