Integrated Care May Improve Migraine and Chronic Tension-Type Headache

woman, hands head, headache, migraine, pain
Researchers analyzed the efficacy of interdisciplinary multimodal integrated care in patients with chronic migraine and/or tension-type headache.

According to study results published in Complementary Theories in Clinical Practice, headache symptoms and functioning in patients with chronic migraine and/or tension-type headaches can be improved with an integrated care approach.

To determine whether patients with chronic migraine or tension-type headache might benefit from an interdisciplinary multimodal integrated care program, researchers conducted a prospective observational study of 158 patients (mean age, 41.8±13.2 years) who underwent inpatient, outpatient, and/or semi-stationary treatment with conventional or complementary headache treatment. They assessed patients for headache frequency, as well as pain, medication use, quality of life, function, depression and anxiety, and pain self-efficacy.

Related Articles

Of patients initially included, 51 either discontinued treatment (39; 24.7%) or were lost to follow-up (12; 7.6%). These patients were younger on average (P =.017), and had a higher headache frequency (P =.013). A majority of the population (80.4%) had migraine and underwent outpatient treatment (85.4%). Patients experienced a mean 17±8.8 headache days/month, used triptans on 4.4±5.4 days/month, and had a mean pain intensity of 5.6±1.8 on a 0 to 10 visual analog scale.

Regardless of treatment type, headache frequency decreased an average of 5.6 (from 17 to 11.4) days at treatment end and 6.4 (to 10.6) days at 6-month follow-up (P <.001). Researchers discovered similar reductions for pain intensity, pain bothersomeness, perceived sensory and affective pain, anxiety, depression, use of triptans and analgetics, and headache-specific disability, as well as quality of life, pain-specific self-efficacy, and patient-specific function (all P <.001).

The investigators noted several study limitations, including its observational design and a lack of a control group.

“Integrated care on an inpatient, outpatient and/or semi-stationary basis significantly decreased patients’ headache frequency,” said the authors. “Further positive effects were found on quality of life, depression, anxiety, self-efficacy, and drug intake. While more research is needed to reach conclusive judgments, the integrated care model assessed here can be preliminarily considered an effective treatment for patients with migraine and/or tension-type headache.”


Cramer H, Hehlke M, Vasmer J, et al. Integrated care for migraine and chronic tension-type headaches: A prospective observational study. Complement Ther Clin Pract. 2019;36:1-6.

This article originally appeared on Clinical Pain Advisor