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Lay Trainers With Migraine for a Home‐Based Behavioral Training: A 6‐Month Follow‐Up Study
Author(s) -
Mérelle Saskia Y.M.,
Sorbi Marjolijn J.,
Van Doornen Lorenz J.P.,
Passchier Jan
Publication year - 2008
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2007.01043.x
Subject(s) - migraine , medicine , confidence interval , randomized controlled trial , physical therapy , quality of life (healthcare) , nursing
Objective.— To evaluate the changes at 6‐month follow‐up after a home‐based behavioral training (BT) provided by lay trainers with migraine to small groups of fellow patients. Background.— The need for self‐management programs and cost‐effective treatments gave rise to this study. Methods.— In a previous randomized controlled trial, we compared the BT group with a waitlist‐control group, receiving usual care. The control group was trained directly after their waitlist period. The present study examined the follow‐up results in both groups and measurements were held pre BT, post BT, and at 6‐month follow‐up. Results.— Six months after BT, 42% was categorized as responders (≥−50% decrease in attack frequency), 42% did not change (−49 to 49%), and 16% responded adversely (≥50% increase). In the group as a whole (n = 95), attack frequency significantly decreased from 3.0 attacks at baseline to 2.5 post BT and to 2.3 at 6‐month follow‐up (−23%, medium effect size 0.6). The strong improvements of perceived control over and self‐confidence in attack prevention were maintained at follow‐up. Disability and health status were unchanged but quality of life significantly improved over time ( P = .007). BT was more beneficial for patients who entered the training with a high attack frequency. Linear regression analysis demonstrated that a stronger belief at baseline that the occurrence of migraine is due to chance (external control) significantly predicted a lower attack frequency at follow‐up. Conclusion.— Lay trainers with migraine can train small groups of fellow patients at home in behavioral attack prevention. At 6‐month follow‐up, attack frequency and quality of life were significantly but modestly improved and feelings of control and self‐confidence remained strongly improved.