Outcomes of a headache-specific cross-sectional multidisciplinary treatment program.
OBJECTIVE
Chronic headache is a disabling disorder that is frequently poorly managed in general clinical practice.


OBJECTIVE
To investigate primary (headache frequency in days/month) and secondary (headache-related disability, lost work/school time, anxiety and depression, amount and intake frequency of acute medication) 12-month outcomes of a headache-specific cross-sectional outpatient and inpatient multidisciplinary treatment program using a dedicated computer system for data collection and corresponding between integrated care team in a tertiary headache center and practicing headache specialists.


BACKGROUND
A need for integrated headache care using comprehensive and standardized assessment for diagnosis of headache, psychiatric comorbidity, and burden of disease exists. There are little published data on long-term efficacy of multidisciplinary treatment programs for chronic headache.


METHODS
A prospective, observational, 12-month, follow-up study.


METHODS
Prospectively recruited consecutive patients with frequent difficult-to-treat headaches (n = 201; 63 migraine, 11 tension-type headache, 59 combined migraine/tension-type headache, and 68 medication overuse headache) were enrolled. Outcome measures included prospective headache diaries, a medication survey, Migraine Disability Assessment, 12-item short form health survey, and the Hospital Anxiety and Depression Scale.


RESULTS
The primary outcome of a reduction of ≥50% of headache frequency (days/month) was observed in 62.7%. Mean headache frequency decreased from 14.4 ± 8.2 to 7.6 ± 8.3 days/month, P < .0001. Secondary outcomes improved significantly in the total cohort and all headache subgroups. Predictors for good outcome were younger age, few days lost at work/school, and familiarity with progressive muscle relaxation therapy at baseline.


CONCLUSIONS
The present analysis provided support for a cross-sectional multidisciplinary integrated headache-care program.
Headache Center Berlin, Sankt Gertrauden Krankenhaus Berlin, Germany. tomwallasch@aol.com
Thomas-Martin
TM
Wallasch
Andreas
A
Angeli
Peter
P
Kropp
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D011331:Private Practice; D011446:Prospective Studies; D018781:Tension-Type Headache / Q000523:psychology / Q000628:therapy*; D062606:Tertiary Care Centers; D016896:Treatment Outcome