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A flexible format interdisciplinary treatment and rehabilitation program for chronic daily headache: patient clinical
Pamela M Barton1, Geoffrey R Schultz, John F Jarrell
1Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada; Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Objective:
To describe the demographics, diagnoses, program duration, human resource utilization and outcomes of patients with chronic daily headache treated in an ambulatory, interdisciplinary, flexible format, treatment and rehabilitation program.
Background:
Research indicates that multidisciplinary care is an effective approach to manage chronic daily headache, but little is known about the resources needed for effective care.
Methods:
The study was a secondary data analysis within a cohort design of previously collected data. Patients completed questionnaires and outcome measures on admission and discharge. Diagnoses were extracted from patient charts by professional health records personnel. A central scheduling database provided patient-specific clinician care hours by discipline and type (direct, indirect, group) as well as overall program duration.
Results:
One hundred and eighteen patients were studied (mean age 41.1 ± 10.4 [x ± SD], 80% female). Sixty-two patients (52.5%) completed the program ("completers"). Migraine was the most common diagnosis. Thirty-six percent of patients had medication overuse. Average pain, mood, disability, and quality of life were significantly improved in completers (P < .001). They utilized 76 ± 45.1 (x ± SD ) total hours of care delivered over a mean of 129.7 ± 66.1 weeks.
Conclusion:
Our study provides evidence that ambulatory, interdisciplinary, flexible format, treatment and rehabilitation programs are effective in the treatment of chronic daily headache, and we provide data on the resources used by our program in the treatment and rehabilitation of these patients.
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