Meer grip op migraine 6 maanden na de gedragsmatige zelfmanagement training door lekentrainers met migraine

Abstract

More control over migraine 6 months after the behavioural self-management training by lay trainers with migraine Despite the availability of evidence-based treatments for migraine many patients do not seek medical treatment. The primary aim of this study was to evaluate the changes at 6-month follow-up after a behavioural self-management training (SMT) provided by lay trainers with migraine to small groups at home. We previously demonstrated in a RCT the short-term effectiveness on headache improvement, though it was modest when compared with the efficacy of clinical psychologists. However, large effects for self-efficacy and perceived control over attack prevention were achieved. The present follow-up data showed that six months after SMT 42% could be categorized as responders (≥50% decrease in attack frequency), 42% did not change and 16% responded adversely. In the group as a whole (n=95) attack frequency significantly decreased from 3.0 attacks at baseline to 2.5 post-SMT and to 2.3 at 6-month follow-up (-23%, medium effect size .6). The strong improvements of perceived control over and self-confidence in attack prevention were maintained at follow-up. Disability and health status were not changed, however, quality of life significantly improved over time (p<.01). SMT was also more beneficial for patients who entered the training with a high attack frequency. In conclusion, home-based lay trainers with migraine can train small groups of fellow patients in behavioural techniques. At 6-month follow-up attack frequency and quality of life were modestly improved, and feelings of control and self-confidence remained strongly improved.