Multidisciplinary headache treatment with work-focus in Norway: An observational study

BackgroundHeadache-related sick leave is increasing in Norway. In cooperation with the Norwegian Labour and Welfare Administration we established the first Norwegian multidisciplinary headache clinic for patients with current or recurrent sick leave due to headaches. The primary objective of this study was to evaluate treatment effects on headache frequency and sick leave, and secondly to identify predictors for improvement and return-to-work.MethodsA team comprising neurologists, nurses, physiotherapists, psychologists, and job specialists treated patients aged 18-67 years with headache-related sick leave. Validated questionnaires and semi-structured interviews were conducted at baseline, 3, 6, and 12 months. Mixed effects linear and logistic regression was performed with headache days and sick leave as outcomes.ResultsOne hundred and one patients completed the 12-month follow-up. The median monthly headache days decreased from 24 (Interquartile range [IQR], 15.5-30) at baseline to 10 (IQR, 4-20) at 12 months (p < 0.001). Headache-related sick leave declined from 53.5% to 33.7% (p < 0.001). Migraine diagnosis and long-term sick leave at baseline negatively predicted for return-to-work, while female sex and low baseline headache frequency predicted favorable clinical outcomes.ConclusionMultidisciplinary treatment reduced headache frequency and increased work attendance. Our findings have potential implications for healthcare policy and resource allocation.