Abstract
Background
Little are known about the effects of non‐pharmacological interventions among medication‐overuse headache (MOH) patients, although non‐pharmacological approaches combined with pharmacological treatment are recommended. The objective was to evaluate the effect of an educational program as an add‐on to standard treatment.
Methods
MOH patients were randomized (1:1) in a single‐center setting to standard treatment with 12 weeks of education (I‐group) versus standard treatment (C‐group). The primary outcome was reduction in headache days/last month at nine months’ follow‐up. Secondary outcomes were headache intensity, acute medication intake, bothersomeness, disability, physical activity, and patient satisfaction. The between‐group differences were analyzed using a mixed‐effects model for repeated measurements with a between group factor (I‐group vs. C‐group) and a time factor (baseline, four months and nine months).
Results
Ninety‐eight patients were randomized (I‐group: n=48, C‐group: n= 50), with 40 and 39 patients completing the study, respectively. Intention‐to‐treat analyses showed that both groups experienced statistically significant reductions in headache days/last month (I‐group: ‐4±6 days (95% CI 2.47; 5.95), p<0.001) versus C‐group: ‐4±9 days ((95% CI 1.53; 6.79), p=0.003), but there were no significant differences between groups (mean±SE):Δ: 0.7 days ((95% CI, ‐2.50; 3.93), p= 0.66). At follow‐up, 85% from the I‐group and 86% from C‐group, no longer fulfilled the criteria for MOH.
Conclusion
The compliance rate was high, indicating that patients were motivated for receiving education, but we found no additional benefits of adding an educational program to standard treatment. Future research focusing on the MOH complexity, group heterogeneity, duration, and content of educational programs is warranted.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2MY0Z3C
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