Voerman Jessica S, Klerk Cora de, Mérelle Saskia Y M, Aartsen Elise, Timman Reinier, Sorbi Marjolijn J, Passchier Jan
Department of Psychiatry, Medical Psychology and Psychotherapy Section, Erasmus MC University Medical Centre, The Netherlands.
Cephalalgia. 2014 Apr;34(5):357-64. doi: 10.1177/0333102413515337. Epub 2013 Dec 10.
Behavioral migraine approaches are effective in reducing headache attacks. Availability of treatment might be increased by using migraine patients as trainers. Therefore, Mérelle and colleagues developed and evaluated a home-based behavioral management training (BMT) by lay trainers (1). The maintenance of effects at long-term follow-up is studied in the present study.
Measurements were taken pre-BMT (T0), post-BMT (T1), at six-month follow-up (T2), and at long-term follow-up, i.e. two to four years after BMT (T3). Data of 127 participants were analyzed with longitudinal multi-level analyses.
Short-term improvements in attack frequency and self-efficacy post-BMT were maintained at long-term follow-up ( DT0T3 = -.34 and DT0T3 = .69, respectively). The level of internal control that increased during BMT decreased from post-BMT to long-term follow-up ( DT0T3 = .18). Quality of life and migraine-related disability improved gradually over time ( DT0T3 = .45 and DT0T3 = -.26, respectively).
Although the results should be interpreted with caution because of the lack of a follow-up control group and the inability to gather information about additional treatments patients may have received during the follow-up period, the findings suggest that lay BMT for migraine may be beneficial over the long term. If so, this could make migraine treatments more widely available.
行为性偏头痛治疗方法在减少头痛发作方面有效。将偏头痛患者作为培训者可能会增加治疗的可及性。因此,梅雷尔及其同事开发并评估了由非专业培训者进行的家庭行为管理训练(BMT)(1)。本研究对长期随访时效果的维持情况进行了研究。
在BMT前(T0)、BMT后(T1)、六个月随访时(T2)以及长期随访时(即BMT后两到四年,T3)进行测量。对127名参与者的数据进行纵向多层次分析。
BMT后发作频率和自我效能的短期改善在长期随访时得以维持(分别为DT0T3 = -.34和DT0T3 = .69)。BMT期间增加的内控水平从BMT后到长期随访时有所下降(DT0T3 = .18)。生活质量和偏头痛相关残疾随时间逐渐改善(分别为DT0T3 = .45和DT0T3 = -.26)。
尽管由于缺乏随访对照组以及无法收集关于患者在随访期间可能接受的其他治疗的信息,结果应谨慎解读,但研究结果表明,非专业人员进行的偏头痛BMT可能长期有益。如果是这样,这可能会使偏头痛治疗更广泛地可得。