title: Anthroposophic therapy for migraine: a two-year prospective cohort study in routine outpatient settings.
abstract: METHODS
  Anthroposophic treatment for migraine is provided by physicians and includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 45 consecutive adult outpatients (89% women) starting anthroposophic treatment for migraine under routine conditions. Main outcomes were Average Migraine Severity (physician and patient ratings 0-10, primary outcome), Symptom Score (patient rating, 0-10), and quality of life (SF-36); main follow-up time point was after six months.
  
  
  RESULTS
  The anthroposophic treatment modalities used were medications (67% of patients), eurythmy therapy (38%), art therapy (18%), and rhythmical massage therapy (13%). Median therapy duration was 105 days. In months 0-6, conventional prophylactic antimigraine medications were used by 14% (n=5/36) of evaluable patients. From baseline to six-month follow-up, physician-rated Average Migraine Severity improved by 3.14 points (95% confidence interval 2.40-3.87, p<0.001); patient-rated Average Migraine Severity improved by 2.82 points (2.05-3.64, p<0.001); and Symptom Score improved by 2.32 points (1.68-2.95, p<0.001). In addition, three SF-36 scales (Social Functioning, Bodily Pain, Vitality), the SF-36 Physical Component summary measure, and the SF-36 Health Change item improved significantly. All improvements were maintained at last follow-up after 24 months. Patients not using conventional prophylactic antimigraine medications had improvements similar to the whole cohort.
  
  
  CONCLUSIONS
  Patients with migraine under anthroposophic treatment had long-term improvement of symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may be useful in the long-term care of patients with migraine.
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany.
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hamre
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Witt
authors.forename: Gunver S
authors.initials: GS
authors.lastname: Kienle
authors.forename: Anja
authors.initials: A
authors.lastname: Glockmann
authors.forename: Renatus
authors.initials: R
authors.lastname: Ziegler
authors.forename: Andreas
authors.initials: A
authors.lastname: Rivoir
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
authors.forename: Helmut
authors.initials: H
authors.lastname: Kiene