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Published on: June 2, 2014
Outcome of a multidisciplinary approach to pediatric migraine at 1, 2, and 5 years
Marielle A Kabbouche1, Scott W Powers, Anna-Liisa B Vockell
1Division of Neurology, Cincinnati Children's Hospital Medical Center, OH, USA.
Insights
Multidisciplinary treatment significantly improves pediatric headaches, reducing frequency, severity, and school absences long-term. Patients with less severe initial symptoms benefited most, highlighting the need for consistent follow-up for those with severe presentations.
Area of Science:
- Pediatric Neurology
- Headache Medicine
- Clinical Outcomes Research
Background:
- Childhood headaches are prevalent and can persist into adulthood.
- Limited research exists on the long-term effectiveness of pediatric headache management.
Purpose of the Study:
- To evaluate the long-term efficacy of multidisciplinary treatment for childhood headaches.
- To assess outcomes 1, 2, and 5 years post-initial treatment.
Main Methods:
- Assessed headache frequency, severity, duration, school absences, and treatment response at baseline and 1, 2, and 5 years.
- Utilized independent sub-groups for follow-up evaluations.
Main Results:
- Significant reductions in headache frequency (P < .001) and severity (P < .01) were observed at 1, 2, and 5 years.
- School days missed per month decreased markedly from baseline to 5 years (P < .001).
- Patients with less severe initial headaches and no follow-up showed sustained improvement.
Conclusions:
- Multidisciplinary care is effective for pediatric headaches, improving key outcome measures.
- Regular follow-up is crucial for children presenting with more severe initial headache symptoms.
Objective:
To assess the long-term effectiveness and outcome of multidisciplinary treatment of childhood headaches 1, 2, and 5 years after initial treatment.
Background:
Headaches are a common problem for children and adolescents and for many patients continue into adulthood. Outcome research for pediatric migraine headaches is limited, thus restricting knowledge of the effectiveness of long-term management and outcome.
Methods:
Headache characteristics were assessed at the initial visit and were reevaluated 1, 2, and 5 years later in independent sub-groups of consecutive patients. These characteristics included headache frequency, severity, average duration, school absences, and overall perceived response to treatment.
Results:
At 1 year, 96 patients were evaluated (mean age = 11.0 +/- 3.4, 59% females), 69 patients at 2 years (mean age = 10.6 +/- 3.4, 48% females), and 32 at 5 years (mean age = 10.5 +/- 3.9, 66% females). The headaches were reported as better in 94% at 1 year, 85% at 2 years, and 94% at 5 years. The initial frequency was at 13.4 +/- 10.8 headaches per month, 4.9 +/- 7.0 at 1 year (P < .001), 4.7 +/- 7.6 at 2 years (P < .001), and 4.5 +/- 7.5 at 5 years (P < .001). The severity decreased from 6.8 +/- 1.8 to 5.1 +/- 2.3 at 1 year (P < .001), to 5.0 +/- 2.4 at 2 years (P < .001), and to 4.6 +/- 2.5 at 5 years (P < .01). The school days missed per month showed a marked decrease from 4.5 +/- 9.5 at initial visit to 1.55 +/- 2.8 at 5 years (P < .001). Patients that were only seen at their initial visit and did not choose to return for follow-up had less frequent and shorter duration headaches on initial visit when compared with the rest of the sample and continued to be doing well at the 1-, 2-, and 5-year assessments.
Conclusions:
Multidisciplinary treatment was found to be effective for children and adolescents with improvement of multiple outcome variants of pediatric migraine care, including frequency, severity, and school days missed. Patients who did not return to follow-up evaluation were more likely to have less frequent and shorter duration headaches at initial presentation. Regular follow-up care is needed for those children with more severe initial headache presentation.
