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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 ISSN 2044-6055.
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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 Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > 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 (Creative Commons) | ||||||
Date of first compliant deposit: | 27 March 2018 | ||||||
Date of first compliant Open Access: | 27 March 2018 | ||||||
RIOXX Funder/Project Grant: |
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