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Non-pharmacological self-management for people living with migraine or tension-type headache : a systematic review including analysis of intervention components.
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Probyn, Katrin, Bowers, Hannah, Mistry, Dipesh, Caldwell, Fiona, Underwood, Martin, Patel, Shilpa, Sandhu, Harbinder, Matharu, Manjit and Pincus, Tamar (2017) Non-pharmacological self-management for people living with migraine or tension-type headache : a systematic review including analysis of intervention components. BMJ Open, 7 (8). e016670. doi:10.1136/bmjopen-2017-016670
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WRAP-non-pharmacological-self-management-people-living-migraine-tension-type-headache-Underwood-2017.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (853Kb) | Preview |
Official URL: http://dx.doi.org/10.1136/bmjopen-2017-016670
Abstract
OBJECTIVES:
To assess the effect of non-pharmacological self-management interventions against usual care, and to explore different components and delivery methods within those interventions
PARTICIPANTS:
People living with migraine and/or tension-type headache
INTERVENTIONS:
Non-pharmacological educational or psychological self-management interventions; excluding biofeedback and physical therapy.We assessed the overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption in meta-analysis.We also provide preliminary evidence on the effectiveness of intervention components and delivery methods.
RESULTS:
We found a small overall effect for the superiority of self-management interventions over usual care, with a standardised mean difference (SMD) of -0.36 (-0.45 to -0.26) for pain intensity; -0.32 (-0.42 to -0.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (-0.66 to -0.40)). We did not find an effect on headache frequency (SMD=-0.07 (-0.22 to 0.08)).Assessment of components and characteristics suggests a larger effect on pain intensity in interventions that included explicit educational components (-0.51 (-0.68 to -0.34) vs -0.28 (-0.40 to -0.16)); mindfulness components (-0.50 (-0.82 to -0.18) vs 0.34 (-0.44 to -0.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (-0.72 to -0.40) vs -0.39 (-0.52 to -0.27)) and larger effects on mood in interventions including a cognitive-behavioural therapy (CBT) component with an SMD of -0.72 (-0.93 to -0.51) compared with those without CBT -0.41 (-0.58 to -0.24).
CONCLUSION:
Overall we found that self-management interventions for migraine and tension-type headache are more effective than usual care in reducing pain intensity, mood and headache-related disability, but have no effect on headache frequency. Preliminary findings also suggest that including CBT, mindfulness and educational components in interventions, and delivery in groups may increase effectiveness
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Migraine -- Treatment, Tension headache -- Treatment | ||||||
| Journal or Publication Title: | BMJ Open | ||||||
| Publisher: | BMJ | ||||||
| ISSN: | 2044-6055 | ||||||
| Official Date: | 11 August 2017 | ||||||
| Dates: |
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| Volume: | 7 | ||||||
| Number: | 8 | ||||||
| Article Number: | e016670 | ||||||
| DOI: | 10.1136/bmjopen-2017-016670 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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