Longitudinal Analysis of Patient‐Reported Outcomes From an Interdisciplinary Pediatric Pain Rehabilitation Program for Children With Chronic Migraine and Headache

Benore, Ethan; Webster, Erin; Wang, Lu; Banez, Gerard A.

doi:10.1111/head.13389

Cited by 18 publications

(11 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The majority of patients suffered from any type of migraine. Considering the psychosocial impairment that migraine has already in young patients, it seems compelling that these patients in particular have a need for intensified therapy [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

et al. 2022

View full text Add to dashboard Cite

Background More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. Methods One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy. Results Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects. Conclusions The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion. Trial registration DRKS00027523, retrospectively registered.

show abstract

Section: Discussionmentioning

confidence: 99%

Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

et al. 2022

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Unimodal or bimodal interdisciplinary treatment programs have been associated with improvement in headache frequency in children and adolescents (25)(26)(27)(28). However, there is limited data on the treatment effects of interdisciplinary treatment programs for children and adolescents with headaches (19). Especially, there are only a few prospective studies published, mainly investigating all types of pain in children and adolescents (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

“…The mean of 35.65(±34. 19) days was reported (median = 18), with girls presenting on average 20.7 more headache days than boys (W = 635.5, p = 0.024). The overall difference between headache diagnoses was still considerable (Kruskal-Wallis test, ߯ ଶ (3) = 17.096, p < 0.001), but the difference between patients with chronic and episodic migraine was not significant anymore (W = 51, p-value = 0.112).…”

Section: Headache Days At Baseline and After Group Therapymentioning

confidence: 99%

See 1 more Smart Citation

An interdisciplinary outpatient therapy program for children and adolescents with headache - real world data

Sobe

Richter

Berner

et al. 2022

Preprint

View full text Add to dashboard Cite

Background/ Objective More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. We investigate the effects of an outpatient interdisciplinary headache program for children, adolescents and their parents. Methods 91 patients suffering from frequent headaches were treated in a 15 hour group program. Parents received 7 hours of therapy. At the beginning of the therapy program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were collected. The primary endpoint was reduction in headache frequency, secondary endpoint reduction in PedMidas. Results 75 children and adolescents (9-18 years, median = 14; 66.7% female) and their parents provided prospective patient reported outcome measures. Patients were diagnosed with any form of migraine or tension type headache or a combination of both. 6 and 12 months after completion of the therapy program patients reported reduced headache frequency (headache days in the last three months median at baseline: 30; T1: 18 days; T2: 13 days). Linear mixed models revealed significant reduction over time (T0/T1 p = 0,002; T0/T2 p = 0,001). In addition, reduced headache disability has been reported 6 and 12 months after therapy (PedMidas median T0= 30, T1=15, T2=7; p<0,001 and p<0,001 respectively). Conclusions The interdisciplinary headache therapy program for children and adolescents, reported here, reduces headache frequency and headache related disability significantly in a period of 6-12 month following its completion. Comparative studies of children and adolescents with headaches in general outpatient treatment are needed to further describe the therapeutic gains of the program.

show abstract

“…One of the few pediatric inpatient IIPT programs, the Functional Independence Restoration (FIRST) program, is located at Cincinnati Children’s Hospital on the inpatient rehabilitation unit. Emerging clinical research shows that IIPT is effective at reducing functional disability among most patients [ 47 , 48 , 49 ], and that those functional improvements sustain over time for many. However, few studies have investigated possible secondary benefits of such programs on other important psychological [ 50 ] or sleep-related [ 51 ] outcomes that may also have profound impacts on improving functioning and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Sleep among Youth with Severely Disabling Chronic Pain: Before, during, and after Inpatient Intensive Interdisciplinary Pain Treatment

et al. 2021

View full text Add to dashboard Cite

Poor sleep is commonly reported in pediatric chronic pain. There are signals that intensive interdisciplinary pain treatments (IIPT) may inadvertently improve objective sleep, but this claim cannot be substantiated without baseline sleep data prior to IIPT. This study followed the objective sleep/wake patterns (e.g., duration, quality, timing, consistency) of pediatric patients with severely functionally disabling chronic pain before, during, and after inpatient IIPT (the Functional Independence Restoration Program—“FIRST Program”), alongside a similarly-disabled chronic pain Comparison Group. The final sample included N = 10 FIRST Patients and N = 9 Comparison Group patients. At baseline, the whole sample showed healthy sleep duration (~9 h), average sleep efficiency <90%, late sleep onset and offset (mean = 11:56 p.m.–8:50 a.m.), and highly inconsistent sleep schedules night to night. During IIPT, FIRST Patients maintained healthy sleep durations, moved sleep schedules 2 h earlier, and decreased timing and duration variability by >60 min while the Comparison Group maintained similar sleep to baseline. At follow up (1–2 months later), FIRST Patients’ sleep schedules shifted later but were still less variable than at baseline. Results point to the malleability of sleep/wake patterns within treatment contexts with strict environmental control but suggest that these gains may be difficult for youth with chronic pain to maintain in the home environment.

show abstract

Longitudinal Analysis of Patient‐Reported Outcomes From an Interdisciplinary Pediatric Pain Rehabilitation Program for Children With Chronic Migraine and Headache

Abstract: Children with chronic headache and migraine who are severely functionally impaired demonstrated linear improvement in pain-specific patient-reported outcomes over time; however, there remains a need for improved methodology in analyzing response to IIPT programs.

Cited by 18 publications

References 59 publications

Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

An interdisciplinary outpatient therapy program for children and adolescents with headache - real world data

Sleep among Youth with Severely Disabling Chronic Pain: Before, during, and after Inpatient Intensive Interdisciplinary Pain Treatment

Contact Info

Product

Resources

About