title: Evaluating integrated headache care: a one-year follow-up observational study in patients treated at the Essen headache centre.
abstract: BACKGROUND
  Outpatient integrated headache care was established in 2005 at the Essen Headache Centre in Germany. This paper reports outcome data for this approach.
  
  
  METHODS
  Patients were seen by a neurologist for headache diagnosis and recommendation for drug treatment. Depending on clinical needs, patients were seen by a psychologist and/or physical therapist. A 5-day headache-specific multidisciplinary treatment programme (MTP) was provided for patients with frequent or chronic migraine, tension type headache (TTH) and medication overuse headache (MOH). Subsequent outpatient treatment was provided by neurologists in private practice.
  
  
  RESULTS
  Follow-up data on headache frequency and burden of disease were prospectively obtained in 841 patients (mean age 41.5 years) after 3, 6 and 12 months. At baseline mean headache frequency was 18.1 (SD = 1.6) days per month, compared to measurement at 1 year follow-up a mean reduction of 5.8 (SD = 11.9) headache days per month was observed in 486 patients (57.8%) after one year (TTH patients mean: -8.5 days per month; migraine mean: -3.2 days per month, patients with migraine and TTH mean: -5.9 days per month). A reduction in headache days ≥ 50% was observed in 306 patients (36.4%) independent of diagnosis, while headache frequency remains unchanged in 20.9% and increase in 21.3% of the patient.
  
  
  CONCLUSIONS
  Multidisciplinary outpatient headache centres offer an effective way to establish a three-tier treatment offer for difficult headache patients depending on clinical needs.
authors: Headache Centre, Department of Neurology, University Duisburg-Essen, Essen, Germany. Charly.Gaul@gmx.de.
authors: Charly
authors: C
authors: Gaul
authors: Julia
authors: J
authors: Brömstrup
authors: Günther
authors: G
authors: Fritsche
authors: Hans C
authors: HC
authors: Diener
authors: Zaza
authors: Z
authors: Katsarava
mesh_terms: D000328:Adult; D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D020773:Headache Disorders / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*