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.