A Flexible Format Interdisciplinary Treatment and Rehabilitation Program for Chronic Daily Headache: Patient Clinical Features, Resource Utilization and Outcomes. Issue 8 (26th May 2014)

• Record Type: Journal Article
• Authors: Barton, Pamela M.; Schultz, Geoffrey R.; Jarrell, John F.; Becker, Werner J.
• Is Part Of: Headache. Volume 54:Issue 8(2014)
• Page Start: 1320
• Page End: 1336
• Publication Date: 2014-05-26
• Subjects: Headache -- Periodicals; Headache -- Periodicals; 616.8491
• DOI: 10.1111/head.12376
• Languages: English
• ISSNs: 0017-8748

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="head12376-sec-0001" sec-type="section"> <title>Objective</title> <p>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.</p> </sec> <sec id="head12376-sec-0002" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="head12376-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="head12376-sec-0004" sec-type="section"> <title>Results</title> <p>One hundred and eighteen patients were studied (mean age <inline-formula><alternatives><inline-graphic mimetype="image" xlink:href="ark:/27927/pgh17zxjv39" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink" /><mml:math altimg="urn:x-wiley:00178748:media:head12376:head12376-math-5001" display="inline" overflow="scroll" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mn mathvariant="bold">4</mml:mn><mml:mn mathvariant="bold">1</mml:mn><mml:mo mathvariant="bold">.</mml:mo><mml:mn mathvariant="bold">1</mml:mn><mml:mo>±</mml:mo><mml:mn mathvariant="bold">1</mml:mn><mml:mn mathvariant="bold">0</mml:mn><mml:mo mathvariant="bold">.</mml:mo><mml:mn mathvariant="bold">4</mml:mn><mml:mtext> </mml:mtext><mml:mo mathvariant="bold" stretchy="false">[</mml:mo><mml:mover accent="true"><mml:mi mathvariant="bold">x</mml:mi><mml:mo mathvariant="bold">̅</mml:mo></mml:mover><mml:mo>±</mml:mo><mml:mi mathvariant="bold">S</mml:mi><mml:mo mathvariant="bold">⁢</mml:mo><mml:mi mathvariant="bold">D</mml:mi><mml:mo mathvariant="bold" stretchy="false">]</mml:mo></mml:mrow></mml:math></alternatives></inline-formula>, 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 (<italic>P</italic> < .001). They utilized <inline-formula><alternatives><inline-graphic mimetype="image" xlink:href="ark:/27927/pgh17zxjv7h" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink" /><mml:math altimg="urn:x-wiley:00178748:media:head12376:head12376-math-5002" display="inline" overflow="scroll" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mn mathvariant="bold">7</mml:mn><mml:mn mathvariant="bold">6</mml:mn><mml:mo>±</mml:mo><mml:mn mathvariant="bold">4</mml:mn><mml:mn mathvariant="bold">5</mml:mn><mml:mo mathvariant="bold">.</mml:mo><mml:mn mathvariant="bold">1</mml:mn><mml:mtext> </mml:mtext><mml:mo mathvariant="bold" stretchy="false">(</mml:mo><mml:mover accent="true"><mml:mi mathvariant="bold">x</mml:mi><mml:mo mathvariant="bold">̅</mml:mo></mml:mover><mml:mo>±</mml:mo><mml:mi mathvariant="bold">S</mml:mi><mml:mo mathvariant="bold">⁢</mml:mo><mml:mi mathvariant="bold">D</mml:mi><mml:mo mathvariant="bold" stretchy="false">)</mml:mo></mml:mrow></mml:math></alternatives></inline-formula> total hours of care delivered over a mean of 129.7 ± 66.1 weeks.</p> </sec> <sec id="head12376-sec-0005" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>