Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study
Open accessAbstract
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.
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A person-centered approach that integrates various intervention components is more effective and may enhance personal control and efficacy in headache management.
“A person-centered approach that integrates various intervention components is more effective [28,29] and may enhance personal control and efficacy in headache management [14].”
From Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial (2024) · cites this paper as [28]
The Discussion says the program focused on self-efficacy and that patients learned to manage headaches more effectively. It also associates adherence to combined behavioral, exercise, and relaxation recommendations with better outcomes. But the Conclusion says a controlled trial is needed to establish effectiveness, so the unqualified claim that the integrated approach is more effective goes beyond this observational study. (LLM, conf=0.82)
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“Adherence to existing prophylactic medication is relatively low, and less than 50% use the prophylactic medications as prescribed.(50,51) Many patients using medical prophylactic treatment that have shown effect in MOH experience side effects; 82.”
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Outcomes of a Headache‐Specific Cross‐Sectional Multidisciplinary Treatment Program
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“In contrast, most multidisciplinary studies used telephone interviews or mailing for follow-ups.(13,17,21,22) Just Zeeberg et al(15) applied prospective diaries for documentation like in our study.”
ResultAssociations Between Migraine and the Most Common Psychiatric Co‐Morbidities
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Chronic Headache Due to Overuse of Analgesics and Anti-Migraine Agents
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“Both RCTs(16,17) and 1 nonrandomized study(18) identified baseline headache frequency for intervention and control groups; 2 single-group studies reported this information.(23,24) Intervention Characteristics.”
BackgroundMultidisciplinary Team Treatment Approaches to Chronic Daily Headaches
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“In terms of absolute numbers, compliance in the clinical trial conducted by Lipton et al 33 was slightly higher than that of patients in a regular tertiary headache center, 75 although this may be expected in patients who are more closely monitored during clinical trials.”
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“…desired outcome [106]. negotiation, goal identi fi cation, planning (action planning and coping), evaluation Several theories (such as the goal-setting theory, the health action process approach, and Bandura’s social learning plans are established that describe how to overcome potential barriers.”
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“and the use of a multidisciplinary approach with frequent encounters between provider and patient.(101) Furthermore, those who practice regular aerobic exercise tend to adhere more than those who are instructed on healthy habits and practice relaxation techniques.”
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“Multidisciplinary approaches have been reported as successful and helpful to patients and healthcare providers.(116,153)”
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“11”
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“Materials of the program were based on the recommendations of Gaul et al. (2011) and Rasmussen (1993) (15, 16).”
Method
- Authors
- Gaul, C., van Doorn, C., Webering, N., Dlugaj, M., Katsarava, Z., Diener, H.-C., & Fritsche, G.
- Affiliations
- Essen University Hospital (DE)
- Corresponding author
- Gaul, Charly
- Venue
- The Journal of Headache and Pain
- Published
- 2011-05-05
- Volume
- 12
- Issue
- 4
- Pages
- 475-483
- ISSN
- 1129-2369 (ISSN-L)
- 1129-2377
- PMC
- PMC3139052
- OpenAlex
- W2017444456
- Cited by
- 156
- References
- 30
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 14 · 2021: 7 · 2020: 8 · 2019: 13 · 2018: 13 · 2017: 12 · 2016: 6 · 2015: 13 · 2014: 17 · 2013: 8 · 2012: 10
- FWCI
- 8.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Journal of Headache and Pain (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- migraine, tension-type headache, medication overuse headache, medication adherence, headache frequency, lifestyle modification, pharmacological prophylaxis, relaxation training, headache centers
- MeSH terms
- Adolescent, Adult, Aged, Exercise Therapy, Female, Headache, Humans, Male, Middle Aged, Patient Compliance, Relaxation Therapy, Treatment Outcome, Pain Clinics, Young Adult
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