Comprehensive inpatient treatment for intractable migraine: a prospective long-term outcome study

This paper describes outcome data for 100 patients with severe, intractable, persistent migraine (chronic daily headache), who were admitted to a comprehensive inpatient Head-Pain Treatment Unit for a mean of 8.5 days. Headache, pain-related behavior, depression, sleep disturbance, functional performance, work status, and medication use were assessed at admission, post-discharge (mean = 2.3 weeks) and long-term follow-up (mean = 8.3 months). Significant improvement noted two weeks after discharge was maintained over time. Long-term results revealed a 64% reduction in the mean number of days in a 2-week period with severe to incapacitating headache (6.29 to 2.26), with a corresponding increase in pain-free days (1.03 to 5.40). At follow-up, the frequency of severe headaches was reduced by at least 50% for 75% of the patients. The mean rating of overall improvement was 74%. Patients on work-leave due to pain dropped from 24% to 4%, while the number of working patients rose from 31% to 53%. The data showed statistically significant reductions in days lost to pain, depression, sleep disturbance, and use of symptomatic medication. All the above analyses were significant at P = .000. These results demonstrate the efficacy of the inpatient headache program intervention for this group of patients.