Effectiveness of Multidisciplinary Intervention in the Treatment of Migraine: A Randomized Clinical Trial

Address all correspondence to Dr. W. P. Olszynski, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada.

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Abstract

Objective.—To test the effectiveness of a multidisciplinary management program for migraine treatment in a group, low cost, nonclinical setting.

Design.—A prospective, randomized, clinical trial.

Background.—Although numerous studies document the efficacy of pharmacological migraine management, it is unclear whether an effective long-term management approach exists.

Methods.—Eighty men and women were randomly assigned to 1 of 2 groups. The intervention group consisted of a neurologist and physical therapist intake and discharge, 18 group-supervised exercise therapy sessions, 2 group stress management and relaxation therapy lectures, 1 group dietary lecture, and 2 massage therapy sessions. The control group consisted of standard care with the patient's family physician. Outcome measures included self-perceived pain intensity, frequency, and duration; functional status; quality of life; health status; depression; prescription and nonprescription medication use; and work status. Outcomes were measured at the end of the 6-week intervention and at a 3-month follow-up.

Results.—Forty-one of 44 patients from the intervention group and all 36 patients from the control group completed the study. There were no statistically significant differences between the 2 groups before intervention. Intention to treat analysis revealed that the intervention group experienced statistically significant changes in self-perceived pain frequency (P = .000), pain intensity (P = .001), pain duration (P = .000), functional status (P = .000), quality of life (P = .000), health status (P = .000), pain related disability (P = .000), and depression (P = .000); these differences retained their significance at the 3-month follow-up. There were no statistically significant changes in medication use or work status.

Conclusions.—Positive health related outcomes in migraine can be obtained with a low cost, group, multidisciplinary intervention in a community based nonclinical setting.

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Volume42, Issue9

October 2002

Pages 845-854

Effectiveness of Multidisciplinary Intervention in the Treatment of Migraine: A Randomized Clinical Trial

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Effectiveness of Multidisciplinary Intervention in the Treatment of Migraine: A Randomized Clinical Trial

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