Open AccessEffectiveness of Therapeutic Patient Education for Adults with Migraine. A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Author(s) -
KindelanCalvo Paula,
GilMartínez Alfonso,
ParisAlemany Alba,
PardoMontero Joaquín,
MuñozGarcía Daniel,
AnguloDíazParreño Santiago,
La Touche Roy
Publication year - 2014
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12505
Subject(s) - medicine , meta analysis , randomized controlled trial , medline , strictly standardized mean difference , cinahl , systematic review , confidence interval , physical therapy , quality of life (healthcare) , migraine , psychiatry , psychological intervention , nursing , political science , law
Objective Our aim was to systematically review and meta‐analyze the effectiveness of therapeutic patient education for migraine. Methods A literature search of multiple electronic databases ( MEDLINE , EMBASE , PEDro , CINAHL , and PsychINFO ) was conducted to identify randomized control trials ( RCTs ) published in the E nglish and S panish languages up to and including M ay 2013. Two reviewers independently selected the studies, conducted the quality assessment ( D elphi list), and extracted the results. The P referred R eporting I tems for S ystematic R eviews and M eta‐ A nalyses method was used throughout the systematic review and meta‐analysis. Standardized mean difference ( SMD ) and 95% confidence intervals ( CI s) were calculated for relevant outcome measures (headache frequency, headache disability, self‐efficacy, depressive symptoms, and quality of life) and pooled in a meta‐analysis using the random effects model. Results Fourteen RCT s were included in the systematic review. Only nine studies were included in the meta‐analysis. The median quality score was 6.14 ± 1.29 (range: 5–9). There was strong‐moderate evidence for intermediate‐term effectiveness of therapeutic patient education on headache frequency (five studies: N = 940, SMD = −0.24, 95% CI of −0.48 to −0.01, P = 0.03), headache disability (four studies: N = 799, SMD = −1.02, 95% CI of −1.95 to −0.08, P = 0.03), and quality of life (three studies: N = 674, SMD = 0.36, 95% CI of 0.05–0.67, P = 0.02). There was no evidence for either short‐term or intermediate‐term effectiveness of therapeutic patient education on self‐efficacy or depressive symptoms. Conclusion This systematic review revealed strong‐moderate evidence for intermediate‐term effectiveness of therapeutic patient education for migraine. Further high‐quality RCTs are required for conclusive determination of its effectiveness.