No abstract

For a headache referral population, headache intensity appears to be a major determinant of headache-related disability, and it also correlates, to some extent, with the degree of depression and emotional distress present. Headache frequency was not clearly related to disability or psychological factors.

Headache is one of the most common forms of chronic pain. Approximately 15% of adult Canadians have migraine, 1 although their attack frequency varies widely. Between four and five percent of adults in Spain and the United States have daily or near daily headache. 2 , 3 In France, three percent of the population has headache every day. 4 The majority of individuals with daily or near daily headache can be classified as suffering from either chronic tension type headache or transformed migraine (TM). 2,3 Patients with TM 5 are basically patients with migraine who have developed very frequent, often daily, headaches. Although overuse of symptomatic medications can lead to this syndrome, 6 in many ABSTRACT: Background: Chronic daily headache (CDH: headache on fifteen days a month or more) is one of the most common forms of chronic pain. The relative efficacy of different treatment methods for these patients needs to be determined. Objective: To compare treatment outcomes for patients with CDH treated in a traditional office-based pharmacological treatment program with a second group treated in a multidisciplinary management program. Methods: Patient outcomes were measured using changes in the Headache Disability Inventory (HDI) and the Short-Form-36 (SF-36) over the treatment period. Outcomes from seventy patients treated in an office setting were compared to thirty-seven patients treated in a multidisciplinary headache treatment program. Both groups received similar pharmacological treatment. All patients treated in the office setting and the majority of patients in the multidisciplinary program had transformed migraine. Results: Even though a reduction in headache days per month occurred, mean headache related disability (measured by HDI) and mean Health Related Quality of Life (HRQoL measured by SF-36) did not improve for the patient group treated in the office setting but did improve significantly for the patient group treated in the multidisciplinary headache program. Conclusion: For patients with CDH, headache-related disability and HRQoL is more likely to improve with management in a multidisciplinary headache treatment program as compared to the traditional specialist consultation -family physician office-based setting.RÉSUMÉ: Efficacité d'un programme de traitement multidisciplinaire pour la céphalée quotidienne chronique. Introduction: La céphalée quotidienne chronique (CQC), soit la présence de céphalée 15 jours ou plus par mois, est l'une des formes les plus fréquentes de douleur chronique. L'efficacité relative de différentes méthodes de traitement chez ces patients demeure indéterminée. Objectifs: Comparer les résultats du traitement de patients souffrant de CQC qui ont bénéficié d'un programme de traitement pharmacologique chez leur médecin et ceux de patients traités dans un programme multidisciplinaire. Méthodes: Les résultats chez les patients ont été mesurés par le changement du score du Headache Disability Inventory (HDI) et du Short-Form-36 (SF-36) pendant le traitement. Les résultats de soixa...