Comprehensive/tertiary care for headache: a 6-month outcome study.

Area of Science:

• Neurology
• Public Health
• Health Economics

Background:

• Limited data exists on the efficacy of comprehensive, multidisciplinary treatment centers for severe, refractory headache disorders.
• Assessing program-wide outcomes for such centers is crucial for understanding treatment effectiveness.

Purpose of the Study:

• To evaluate the program-wide outcomes of a comprehensive headache center over the initial six months of treatment.
• To assess improvements in headache frequency, severity, and related functional impairments.

Main Methods:

• Prospective data collection over a 2-year period from new patients at a comprehensive headache center.
• Patients completed monthly questionnaires on headache frequency/severity; a 6-month follow-up was mailed.
• Data analyzed included headache metrics, emergent care visits, work impairment, and treatment satisfaction.

Main Results:

• Mean headache frequency decreased from 5.30 to 3.45 days/week (P<.00001).
• Severe headaches reduced by 56% (median 67%); emergent care visits dropped from 4.39 to 1.67 (P<.00001).
• Work impairment and days incapacitated significantly decreased, with high treatment satisfaction (89%) and overall Goal Attainment score of 72%.

Conclusions:

• Comprehensive headache treatment led to significant improvements in pain control, functioning, and work performance within six months.
• The findings support the cost-effectiveness of matching intensive treatment to complex, refractory headache cases.
• Even with limited medical visits, significant improvements were observed, highlighting the value of specialized care.