title: A flexible format interdisciplinary treatment and rehabilitation program for chronic daily headache: patient clinical features, resource utilization and outcomes.
abstract: OBJECTIVE
  To describe the demographics, diagnoses, program duration, human resource utilization and outcomes of patients with chronic daily headache treated in an ambulatory, interdisciplinary, flexible format, treatment and rehabilitation program.
  
  
  BACKGROUND
  Research indicates that multidisciplinary care is an effective approach to manage chronic daily headache, but little is known about the resources needed for effective care.
  
  
  METHODS
  The study was a secondary data analysis within a cohort design of previously collected data. Patients completed questionnaires and outcome measures on admission and discharge. Diagnoses were extracted from patient charts by professional health records personnel. A central scheduling database provided patient-specific clinician care hours by discipline and type (direct, indirect, group) as well as overall program duration.
  
  
  RESULTS
  One hundred and eighteen patients were studied (mean age 41.1 ± 10.4   [x ± SD], 80% female). Sixty-two patients (52.5%) completed the program ("completers"). Migraine was the most common diagnosis. Thirty-six percent of patients had medication overuse. Average pain, mood, disability, and quality of life were significantly improved in completers (P < .001). They utilized 76 ± 45.1   (x ± SD ) total hours of care delivered over a mean of 129.7 ± 66.1 weeks.
  
  
  CONCLUSIONS
  Our study provides evidence that ambulatory, interdisciplinary, flexible format, treatment and rehabilitation programs are effective in the treatment of chronic daily headache, and we provide data on the resources used by our program in the treatment and rehabilitation of these patients.
authors.affiliation: Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada; Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Barton
authors.forename: Geoffrey R
authors.initials: GR
authors.lastname: Schultz
authors.forename: John F
authors.initials: JF
authors.lastname: Jarrell
authors.forename: Werner J
authors.initials: WJ
authors.lastname: Becker
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods*; D005260:Female; D020773:Headache Disorders / Q000628:therapy*; D006295:Health Resources; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000379:methods; D009788:Occupational Therapy / Q000379:methods; D026741:Physical Therapy Modalities; D011584:Psychology / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: chronic pain; headache; health services needs and demands; multidisciplinary; pain clinics