Skip to main content
Journal cover image

Headache management program improves outcome for chronic headache.

Publication ,  Journal Article
Harpole, LH; Samsa, GP; Jurgelski, AE; Shipley, JL; Bernstein, A; Matchar, DB
Published in: Headache
2003

OBJECTIVE: To determine the feasibility of developing a headache management program and to assess the outcomes of patients referred to the program for treatment of chronic headache. BACKGROUND: Effective headache treatment requires that the patient receives the correct headache diagnosis; that appropriate acute and, if indicated, preventive medications be prescribed; and that the patient receives adequate education, including headache self-management skills. DESIGN/METHODS: A headache management program was established at a northern California staff-model health maintenance organization. Fifty-four patients were enrolled in the program and followed for 6 months. Patients participated in a structured program of group and individual sessions with the program manager. Data collection at baseline and 6 months included the Migraine Disability Assessment (MIDAS), the Short Form-36 Health Survey (SF-36), a patient satisfaction survey, and 2 additional short surveys--one that assessed patient worries about their headaches and another that queried patients on their problems with headache management. RESULTS: All enrolled patients participated in the initial group visit; 74% had at least one additional visit. All but one patient suffered from more than one headache type. Sixty-one percent of patients suffered from migraine headache and 98% from tension-type headache. At baseline, patients were severely disabled, with a mean MIDAS score of 41. At 6 months, MIDAS scores decreased an average of 21.2 points (P <.005). Patients reported 14.5 fewer days with headache over the preceding 3 months (P <.0001) and experienced clinically significant improvements in 6 of the SF-36 subscales. Patients were significantly more satisfied with their headache care (P <.0001), reported less problems with their headache management (P <.0001), and were less worried about their headaches (P <.01). During the intervention, emergency department visits for headache decreased (P <.02). CONCLUSIONS: A headache management program was successfully established. Patients referred to the program experienced significant improvement in headache-related disability and functional health status and reported greater satisfaction with care. Even so, these results were obtained at one site and in a small sample that was not randomized. We currently are conducting a randomized controlled trial to better evaluate the clinical and financial impact of a headache management program for patients with chronic headache.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Headache

DOI

ISSN

0017-8748

Publication Date

2003

Volume

43

Issue

7

Start / End Page

715 / 724

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Program Development
  • Patient Satisfaction
  • Patient Education as Topic
  • Pain Clinics
  • Neurology & Neurosurgery
  • Migraine Disorders
  • Male
  • Humans
  • Headache Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Harpole, L. H., Samsa, G. P., Jurgelski, A. E., Shipley, J. L., Bernstein, A., & Matchar, D. B. (2003). Headache management program improves outcome for chronic headache. Headache, 43(7), 715–724. https://doi.org/10.1046/j.1526-4610.2003.03128.x
Harpole, Linda H., Gregory P. Samsa, Annette E. Jurgelski, Janice L. Shipley, Allan Bernstein, and David B. Matchar. “Headache management program improves outcome for chronic headache.Headache 43, no. 7 (2003): 715–24. https://doi.org/10.1046/j.1526-4610.2003.03128.x.
Harpole LH, Samsa GP, Jurgelski AE, Shipley JL, Bernstein A, Matchar DB. Headache management program improves outcome for chronic headache. Headache. 2003;43(7):715–24.
Harpole, Linda H., et al. “Headache management program improves outcome for chronic headache.Headache, vol. 43, no. 7, 2003, pp. 715–24. Pubmed, doi:10.1046/j.1526-4610.2003.03128.x.
Harpole LH, Samsa GP, Jurgelski AE, Shipley JL, Bernstein A, Matchar DB. Headache management program improves outcome for chronic headache. Headache. 2003;43(7):715–724.
Journal cover image

Published In

Headache

DOI

ISSN

0017-8748

Publication Date

2003

Volume

43

Issue

7

Start / End Page

715 / 724

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Program Development
  • Patient Satisfaction
  • Patient Education as Topic
  • Pain Clinics
  • Neurology & Neurosurgery
  • Migraine Disorders
  • Male
  • Humans
  • Headache Disorders