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Published on: June 2, 2014
Prognostic factors for chronic headache: A systematic review.
Katrin Probyn1, Hannah Bowers2, Fiona Caldwell2
1From the Department of Psychology (K.P., H.B., F.C., T.P.), Royal Holloway, University of London; Warwick Clinical Trials Unit (D.M., M.U.), Warwick Medical School, University of Warwick, Coventry; and Headache Group (M.M.), Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. Katrin.probyn@rhul.ac.uk.
Predictors of poor chronic headache prognosis include depression, anxiety, poor sleep, stress, medication overuse, and low self-efficacy. Many of these factors are modifiable, suggesting potential targets for improving treatment outcomes.
Area of Science:
- Neurology
- Psychiatry
- Evidence-based Medicine
Background:
- Chronic headache, encompassing chronic headache, chronic migraine, and chronic tension-type headache, affects a significant population.
- Predicting prognosis and treatment outcomes in chronic headache is crucial for effective patient management.
Purpose of the Study:
- To systematically review prospective studies to identify predictors of prognosis and treatment outcomes in adults with chronic headache.
- To synthesize evidence on factors influencing the success of preventive treatments for chronic headache.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) with subgroup analyses and prospective cohort studies published since 1980.
- Inclusion criteria: adults with chronic headache, English-language publications.
- Data extraction and quality assessment performed independently by two reviewers using established checklists.
Main Results:
- Moderate-quality evidence identified depression, anxiety, poor sleep, stress, medication overuse, and low self-efficacy as predictors of poor prognosis and unfavorable outcomes.
- Inconclusive evidence was found for treatment expectations, age, age at onset, BMI, employment, and headache features.
Conclusions:
- Several modifiable factors predict poor prognosis and outcomes in chronic headache patients.
- Highlights the need for high-quality longitudinal research on prognostic factors in chronic headache management.
