Ryan Headache Center/Mercy Health Research - St. John's Mercy Medical Group, St. Louis, MO 63104, USA.
Headache. 2010 Apr;50(4):600-12. doi: 10.1111/j.1526-4610.2010.01618.x. Epub 2010 Feb 9.
OBJECTIVE: The objective of this study was to evaluate the effectiveness of the Mercy Migraine Management Program (MMMP), an educational program for physicians and patients. The primary outcome was change in headache days from baseline at 3, 6, and 12 months. Secondary outcomes were changes in migraine-related disability and quality of life, worry about headaches, self-efficacy for managing migraines, emergency room (ER) visits for headache, and satisfaction with headache care. BACKGROUND: Despite progress in the understanding of the pathophysiology of migraine and development of effective therapeutic agents, many practitioners and patients continue to lack the knowledge and skills to effectively manage migraine. Educational efforts have been helpful in improving the quality of care and quality of life for migraine sufferers. However, little work has been performed to evaluate these changes over a longer period of time. Also, there is a paucity of published research evaluating the influence of education about migraine management on cognitive and emotional factors (for example, self-efficacy for managing headaches, worry about headaches). METHODS: In this open-label, prospective study, 284 individuals with migraine (92% female, mean age = 41.6) participated in the MMMP, an educational and skills-based program. Of the 284 who participated in the program, 228 (80%) provided data about their headache frequency, headache-related disability (as measured by the Headache Impact Test-6 (HIT-6), migraine-specific quality of life (MSQ), worry about headaches, self-efficacy for managing headaches, ER visits for headaches, and satisfaction with care at 4 time points over 12 months (baseline, 3 months, 6 months, 12 months). RESULTS: Overall, 46% (106) of subjects reported a 50% or greater reduction in headache frequency. Over 12 months, patients reported fewer headaches and improvement on the HIT-6 and MSQ (all P < .001). The improvement in headache impact and quality of life was greater among those who had more worry about their headaches at baseline. There were also significant improvements in "worry about headaches,""self-efficacy for managing headaches," and "satisfaction with headache care." CONCLUSION: The findings demonstrate that patients participating in the MMMP reported improvements in their headache frequency as well as the cognitive and emotional aspects of headache management. This program was especially helpful among those with high amounts of worry about their headaches at the beginning of the program. The findings from this study are impetus for further research that will more clearly evaluate the effects of education and skill development on headache characteristics and the emotional and cognitive factors that influence headache.
目的:本研究旨在评估 Mercy 偏头痛管理计划(MMMP)的有效性,该计划是一项针对医生和患者的教育计划。主要结果是在 3、6 和 12 个月时从基线开始头痛天数的变化。次要结果是偏头痛相关残疾和生活质量、头痛担忧、管理偏头痛的自我效能、急诊室(ER)就诊头痛和头痛护理满意度的变化。
背景:尽管偏头痛的病理生理学理解和有效治疗药物的发展取得了进展,但许多从业者和患者仍然缺乏有效管理偏头痛的知识和技能。教育工作在改善偏头痛患者的护理质量和生活质量方面发挥了作用。然而,很少有工作来评估这些变化在较长时间内的情况。此外,发表的研究评估偏头痛管理教育对认知和情绪因素(例如,管理头痛的自我效能,头痛担忧)的影响很少。
方法:在这项开放标签、前瞻性研究中,284 名偏头痛患者(92%为女性,平均年龄=41.6)参加了 MMMP,这是一项教育和技能计划。在参加该计划的 284 人中,228 人(80%)提供了他们头痛频率、偏头痛相关残疾(用头痛影响测试-6(HIT-6)衡量)、偏头痛特定生活质量(MSQ)、头痛担忧、管理头痛的自我效能、急诊室就诊头痛和 12 个月内 4 个时间点的护理满意度的数据。
结果:总体而言,46%(106)的受试者报告头痛频率降低了 50%或更多。在 12 个月内,患者报告头痛减少,HIT-6 和 MSQ 改善(均<.001)。在基线时对头痛更担心的患者中,头痛的影响和生活质量的改善更大。“头痛担忧”、“管理头痛的自我效能”和“头痛护理满意度”也有显著提高。
结论:研究结果表明,参加 MMMP 的患者报告头痛频率以及头痛管理的认知和情绪方面都有所改善。该计划在计划开始时对头痛高度担忧的患者中尤其有帮助。这项研究的结果为进一步研究提供了动力,该研究将更清楚地评估教育和技能发展对头痛特征以及影响头痛的情绪和认知因素的影响。
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