Effectiveness of multidisciplinary intervention in the treatment of migraine: A randomized clinical trial

Objective.-To test the effectiveness of a multidisciplinary management program for migraine treatment in a group, low cost, nonclinical setting. Design.-A prospective, randomized, clinical trial. Background.-Although numerous studies document the efficacy of pharmacological migraine management, it is unclear whether an effective long-term management approach exists. Methods.-Eighty men and women were randomly assigned to 1 of 2 groups. The intervention group consisted of a neurologist and physical therapist intake and discharge, 18 group-supervised exercise therapy sessions, 2 group stress management and relaxation therapy lectures, 1 group dietary lecture, and 2 massage therapy sessions. The control group consisted of standard care with the patient's family physician. Outcome measures included self-perceived pain intensity, frequency, and duration; functional status; quality of life; health status; depression; prescription and nonprescription medication use; and work status. Outcomes were measured at the end of the 6-week intervention and at a 3-month follow-up. Results.-Forty-one of 44 patients from the intervention group and all 36 patients from the control group completed the study. There were no statistically significant differences between the 2 groups before intervention. Intention to treat analysis revealed that the intervention group experienced statistically significant changes in self-perceived pain frequency (P=.000), pain intensity (P=.001), pain duration (P=.000), functional status (P=.000), quality of life (P=.000), health status (P=.000), pain related disability (P=.000), and depression (P=.000); these differences retained their significance at the 3-month follow-up. There were no statistically significant changes in medication use or work status. Conclusions.-Positive health related outcomes in migraine can be obtained with a low cost, group, multidisciplinary intervention in a community based nonclinical setting.