Research Submission

Lay Trainers With Migraine for a Home-Based Behavioral Training: A 6-Month Follow-Up Study

Saskia Y.M. Mérelle MSc

Saskia Y.M. Mérelle MSc

From the Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands (S.Y.M. Mérelle and J. Passchier); Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands (S.Y.M. Mérelle, M.J. Sorbi, and L.J.P. van Doornen).

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Marjolijn J. Sorbi PhD

Marjolijn J. Sorbi PhD

From the Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands (S.Y.M. Mérelle and J. Passchier); Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands (S.Y.M. Mérelle, M.J. Sorbi, and L.J.P. van Doornen).

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Lorenz J.P. Van Doornen PhD

Lorenz J.P. Van Doornen PhD

From the Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands (S.Y.M. Mérelle and J. Passchier); Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands (S.Y.M. Mérelle, M.J. Sorbi, and L.J.P. van Doornen).

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Jan Passchier PhD

Jan Passchier PhD

From the Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands (S.Y.M. Mérelle and J. Passchier); Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands (S.Y.M. Mérelle, M.J. Sorbi, and L.J.P. van Doornen).

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First published: 03 October 2008
Citations: 31
S. Mérelle, Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Dr. Molewaterplein 50, Rotterdam, 3000 CA, the Netherlands.

Financial Support: Grant No. 940-31-069 of the Netherlands Organization for Health Research and Development (ZonMw), The Hague, and financial means provided by the Pain Expertise Centre, Erasmus University Medical Center.

Conflict of Interest: None

Abstract

Objective.— To evaluate the changes at 6-month follow-up after a home-based behavioral training (BT) provided by lay trainers with migraine to small groups of fellow patients.

Background.— The need for self-management programs and cost-effective treatments gave rise to this study.

Methods.— In a previous randomized controlled trial, we compared the BT group with a waitlist-control group, receiving usual care. The control group was trained directly after their waitlist period. The present study examined the follow-up results in both groups and measurements were held pre BT, post BT, and at 6-month follow-up.

Results.— Six months after BT, 42% was categorized as responders (≥−50% decrease in attack frequency), 42% did not change (−49 to 49%), and 16% responded adversely (≥50% increase). In the group as a whole (n = 95), attack frequency significantly decreased from 3.0 attacks at baseline to 2.5 post BT and to 2.3 at 6-month follow-up (−23%, medium effect size 0.6). The strong improvements of perceived control over and self-confidence in attack prevention were maintained at follow-up. Disability and health status were unchanged but quality of life significantly improved over time (P = .007). BT was more beneficial for patients who entered the training with a high attack frequency. Linear regression analysis demonstrated that a stronger belief at baseline that the occurrence of migraine is due to chance (external control) significantly predicted a lower attack frequency at follow-up.

Conclusion.— Lay trainers with migraine can train small groups of fellow patients at home in behavioral attack prevention. At 6-month follow-up, attack frequency and quality of life were significantly but modestly improved and feelings of control and self-confidence remained strongly improved.