Behavioral Approaches for Primary Headaches: Recent Advances

Raggi, Alberto; Grignani, Eleonora; Leonardi, Matilde; Andrasik, Frank; Sansone, Emanuela; Grazzi, Licia; D’Amico, Domenico

doi:10.1111/head.13337

Cited by 41 publications

(39 citation statements)

References 86 publications

(249 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Drug treatment, however, is not always needed, and prophylactic treatment is not considered the first line treatment in the vast majority of cases ( 6 , 7 ). In recent years, attention has been increasingly paid to non-pharmacological treatments of headache disorders, chiefly those that are cognitive, behavioral, or psychophysiological in nature, but with some attention to non-invasive neurostimulation ( 8 – 11 ). Overall, significant benefits, typically ranging from 35 to 50%, have been reported for the above-mentioned treatments with respect to reductions in headache frequency.…”

Section: Introductionmentioning

confidence: 99%

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Andrasik

Grazzi²,

Sansone³

et al. 2018

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

Headache disorders are common in children and adolescents. Most of the studies on non-pharmacological treatments have however been carried out on adults. In this review we provide information on recent studies examining non-pharmacological approaches for managing headache in children and adolescents. Our search of SCOPUS for primary studies conducted between January 2010 and July 2018 uncovered 11 controlled studies, mostly addressing behavioral approaches, in which a total of 613 patients with a diagnosis of primary headache, and average age 10.2–15.7 years (30–89% females) were recruited. Non-pharmacological treatments were shown to produce sizeable effects on the classical primary endpoint, i.e., headache frequency, with reductions from baseline ranging between 34 and 78%. Among commonly reported secondary endpoints, particularly disability, quality of life, depression and anxiety, marked improvements were noted as well. Taken as a whole, our findings suggest that non-pharmacological treatments constitute a valid option for the prevention of primary headaches in young age. Future research with higher-quality studies is needed. Particular attention needs to be given to studies that randomize patients to condition, blind researchers in charge of evaluating treatment outcomes, routinely include headache frequency as the primary endpoint, include adequate-length follow-up, address changes in biomarkers of disease and other possible mediators of outcome, and that employ predictive models to enhance the level of evidence for these approaches.

show abstract

Section: Introductionmentioning

confidence: 99%

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Andrasik

Grazzi²,

Sansone³

et al. 2018

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…With regard to the cost for acute medications, in addition to the higher cost herein reported, our data could be used to define an average cost per dose for each of the three main categories of overused drugs: analgesics/non-steroidal anti-inflammatory drugs (around €0.40), triptans (around €6) and opioids (around €0.55). Finally, our results point out the relevance of direct non-medical costs, which received no attention in the evaluation of the cost of headache disorders [6,18,19], and of non-pharmacological treatment, which is increasingly used in the treatment of headache disorders [20][21][22].…”

Section: Discussionmentioning

confidence: 87%

The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data

Raggi

Leonardi

Sansone

et al. 2019

Euro J of Neurology

Self Cite

View full text Add to dashboard Cite

Background and purpose The cost of medication overuse headache (MOH) is underestimated. Our aim was to address the cost‐effectiveness of a structured treatment protocol and to present annual cost estimates. Methods Patients were enrolled on the occasion of a structured treatment protocol, were administered a research protocol addressing direct and indirect costs and were followed up for 3 months. Results Of 176 enrolled patients, 138 completed the study. The 3‐month cost per patient fell from €2989 to €1160: the difference was €696 per month for patients treated in the ward and €466 for those treated in day‐hospital; thus it takes 2–3 months to compensate for the protocol's cost. The per‐person annual costs of MOH were €10 533 (95% confidence interval €8700–12 406): direct healthcare costs accounted for 44.8% and indirect costs for 51.5% of the total MOH cost. The annual MOH cost for Italy is estimated at €13.5 billion (95% confidence interval €11.1–15.9 billion). Conclusion The cost of MOH around the period of a structured treatment protocol is much higher compared to previous estimates. Our protocol is cost‐effective for reducing the economic burden of MOH.

show abstract

“…We retrieved 868 studies from electronic database and 70 from reviews and meta-analyses [17,18,[20][21][22][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. After removing duplicates and applying exclusion criteria, we obtained a final selection of 28 papers [11-15, 23, 48-69] (see flow diagram of studies selection in Fig.…”

Section: Searching Relevant Literature -Resultsmentioning

confidence: 99%

From research to clinical practice: a systematic review of the implementation of psychological interventions for chronic headache in adults

Perlini

Donisi

Piccolo

2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background: Psychological interventions have been proved to be effective in chronic headache (CH) in adults. Nevertheless, no data exist about their actual implementation into standard clinical settings. We aimed at critically depicting the current application of psychological interventions for CH into standard care exploring barriers and facilitators to their implementation. Secondarily, main outcomes of the most recent psychological interventions for CH in adults have been summarized. Methods: We conducted a systematic review through PubMed and PsycINFO in the time range 2008-2018. A quality analysis according to the QATSDD tool and a narrative synthesis were performed. We integrated results by: contacting the corresponding author of each paper; exploring the website of the clinical centers cited in the papers. Results: Of the 938 identified studies, 28 papers were selected, whose quality largely varied with an average %QATSDD quality score of 64.88%. Interventions included CBT (42.85%), multidisciplinary treatments (22.43%), relaxation training (17.86%), biofeedback (7.14%), or other interventions (10.72%). Treatments duration (1 day-9 months) and intensity varied, with a prevalence of individual-basis implementation. The majority of the studies focused on all primary headaches; 4 studies focused on medication-overuse headache. Most of the studies suggest interventions as effective, with the reduction in frequency of attacks as the most reported outcome (46.43%). Studies were distributed in different countries, with a prevalent and balanced distribution in USA and Europe. Ten researches (35.71%) were performed in academic contexts, 11 (39.28%) in clinical settings, 7 (25%) in pain/headache centres. Interventions providers were professionals with certified experience. Most of the studies were funded with private or public funding. Two contacted authors answered to our e-mail survey, with only one intervention implemented in the routine clinical practice. Only in three out of the 16 available websites a reference to the implementation into the clinical setting was reported.

show abstract

Behavioral Approaches for Primary Headaches: Recent Advances

Cited by 41 publications

References 86 publications

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data

From research to clinical practice: a systematic review of the implementation of psychological interventions for chronic headache in adults

Contact Info

Product

Resources

About