A Flexible Format Interdisciplinary Treatment and Rehabilitation Program for Chronic Daily Headache: Patient Clinical Features, Resource Utilization and Outcomes

Authors

  • Pamela M. Barton MD,

    Corresponding author
    1. Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada
    2. Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
    3. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
    • Address all correspondence to P.M. Barton, Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Foothills Medical Centre, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada, email: pamela.barton@albertahealthservices.ca

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  • Geoffrey R. Schultz PhD,

    1. Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada
    2. Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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  • John F. Jarrell MD,

    1. Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada
    2. Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
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  • Werner J. Becker MD

    1. Alberta Health Services Chronic Pain Centre, Calgary, Alberta, Canada
    2. Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
    3. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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  • Conflict of Interest: None.
  • Funding: This work was supported by Alberta Innovates–Health Solutions Health Research Fund [grant no. 200400976].

Abstract

Objective

To describe the demographics, diagnoses, program duration, human resource utilization and outcomes of patients with chronic daily headache treated in an ambulatory, interdisciplinary, flexible format, treatment and rehabilitation program.

Background

Research indicates that multidisciplinary care is an effective approach to manage chronic daily headache, but little is known about the resources needed for effective care.

Methods

The study was a secondary data analysis within a cohort design of previously collected data. Patients completed questionnaires and outcome measures on admission and discharge. Diagnoses were extracted from patient charts by professional health records personnel. A central scheduling database provided patient-specific clinician care hours by discipline and type (direct, indirect, group) as well as overall program duration.

Results

One hundred and eighteen patients were studied (mean age inline image, 80% female). Sixty-two patients (52.5%) completed the program (“completers”). Migraine was the most common diagnosis. Thirty-six percent of patients had medication overuse. Average pain, mood, disability, and quality of life were significantly improved in completers (P < .001). They utilized inline image total hours of care delivered over a mean of 129.7 ± 66.1 weeks.

Conclusion

Our study provides evidence that ambulatory, interdisciplinary, flexible format, treatment and rehabilitation programs are effective in the treatment of chronic daily headache, and we provide data on the resources used by our program in the treatment and rehabilitation of these patients.

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