Abstract
Background and Methods:Anthroposophic treatment for migraine is provided by physicians and includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 45 consecutive adult outpatients (89% women) starting anthroposophic treatment for migraine under routine conditions. Main outcomes were Average Migraine Severity (physician and patient ratings 0-10, primary outcome), Symptom Score (patient rating, 0-10), and quality of life (SF-36); main follow-up time point was after six months.Results:The anthroposophic treatment modalities used were medications (67% of patients), eurythmy therapy (38%), art therapy (18%), and rhythmical massage therapy (13%). Median therapy duration was 105 days. In months 0-6, conventional prophylactic antimigraine medications were used by 14% (n=5/36) of evaluable patients.From baseline to six-month follow-up, physician-rated Average Migraine Severity improved by 3.14 points (95% confidence interval 2.40-3.87, p<0.001); patient-rated Average Migraine Severity improved by 2.82 points (2.05-3.64, p<0.001); and Symptom Score improved by 2.32 points (1.68-2.95, p<0.001). In addition, three SF-36 scales (Social Functioning, Bodily Pain, Vitality), the SF-36 Physical Component summary measure, and the SF-36 Health Change item improved significantly. All improvements were maintained at last follow-up after 24 months. Patients not using conventional prophylactic antimigraine medications had improvements similar to the whole cohort.Conclusions:Patients with migraine under anthroposophic treatment had long-term improvement of symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may be useful in the long-term care of patients with migraine.
Highlights
Migraine affects 14% of adults in Europe every year [1] and is associated with substantial disability, reduced quality of life, reduced work capacity, psychiatric and somatic comorbidity, and increased healthcare use [2,3,4]
The pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may be useful in the long-term care of patients with migraine
Comparing these physicians to Anthroposophic medicine (AM)-certified physicians in Germany with the same four qualifications but without study patients (n = 225), no significant differences were found regarding gender (60.0% vs. 58.5% males), number of years in practice (16.1 ± 6.9 vs. 19.3 ± 8.9), and the proportion of physicians working in primary care (90.0% vs. 92.0%)
Summary
Migraine affects 14% of adults in Europe every year [1] and is associated with substantial disability, reduced quality of life, reduced work capacity, psychiatric and somatic comorbidity, and increased healthcare use [2,3,4]. The World Health Organization has ranked severe migraine attacks among the most disabling medical conditions, along with psychosis, dementia, and quadriplegia [5]. Many migraine patients use complementary therapies [810], sometimes provided by their physicians. Anthroposophic treatment for migraine is provided by physicians and includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 45 consecutive adult outpatients (89% women) starting anthroposophic treatment for migraine under routine conditions. Main outcomes were Average Migraine Severity (physician and patient ratings 0-10, primary outcome), Symptom Score (patient rating, 010), and quality of life (SF-36); main follow-up time point was after six months
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