Self-managed non-pharmacological interventions have been encouraged as an
optimistic option for people with intractable chronic conditions.
The self-management interventions for migraine and
tension-type headache are more effective than usual care in reducing pain
intensity, mood and headache-related disability, but have no effect on headache
frequency.
Self-managed non-pharmacological interventions have been encouraged as an optimistic option for people with intractable chronic conditions. The self-management of migraine and tension-type headaches can be done either alongside pharmacological interventions or as a stand-alone therapy, particularly when other treatment options have failed, or a person prefers a non-pharmacological intervention. Headache management is strongly influenced by behavioral factors; therefore, these treatments are aimed at enabling patients to handle pain and symptoms associated with their headaches more effectively. The basic rationale behind promoting self-management in headache is that people can learn ways to help themselves manage their headaches better and that this can have a positive effect on both physical symptoms and functional capacity. The two common approaches are biofeedback and exercise/physical therapy. However, this study focuses on various approaches, but interventions differ considerably in terms of content and delivery for supporting the use of self-management interventions. In this study, the effect of self-management interventions commonly included in trials in migraine and tension-type headache populations were quantified. Also, the effects of interventions that included specific components compared with those that did not include them were explored. This study was conducted to inform the formation of a complex non-pharmacological intervention for the Chronic Headache Education and Self-Management Study (CHESS). The CHESS aims to develop a sustainable non-pharmacological educational self-management intervention for people with chronic migraine/and or tension-type headache. In this systematic review, the self-management practices by educational and psychological approaches and sustainable interventions without the use of any apparatus were focused without including biofeedback or exercise/physical therapy.
Rationale behind the research:
There are limited evidences in literature about mindfulness-based therapies for non-pharmacological self-management of migraine and headache. Therefore, this research focuses on both mindfulness and acceptance-based approaches for self-management of migraine.
Objective:
To assess the effect of non-pharmacological self-management interventions against usual care, and to explore different components and delivery methods within those interventions.
Study outcome measures
Time Points: Not described
Study outcomes:
The study concluded that
self-management interventions improves many headache-related outcomes but have
no effect on headache frequency when compared with usual care for migraine and
tension-type headache. There occurs some preliminary evidence that delivery of
self-management interventions in groups, including CBT, educational and
mindfulness components, appears to be associated with larger effects. Some evidences
guide research-based decisions about intervention content and delivery details
of self-management interventions that aim to improve patients’ capacity to
manage their headaches.
The
results were significant, but there is need of further research in order to
confirm and consider the optimal duration, and amount of contact hours and
length of self-management interventions to help patients manage their
headaches. Further methodological
research is needed to explore the interactions between components and possible
additive and/or synergistic effects of components in self-management
interventions.
This study clarifies the preliminary assessment of intervention features associated with better outcomes of non-pharmacological self-management of migraine and tension-type headaches.
BMJ Open 2017;7:e016670.
Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components
Probyn K et al.
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