Probyn K, et al. – This study incorporated an inspection of the effect of non–pharmacological self–management interventions for a migraine and tension–type headache against usual care. Furthermore, it investigated the varied components and delivery methods within those interventions. These self–management interventions were discovered to be more effective than usual care in reducing pain intensity, mood and headache–related disability. However, it did not exhibit any effect on the headache frequency. The inclusion of cognitive–behavioural therapy (CBT), mindfulness and educational components in interventions, and delivery in groups possibly resulted in an increase in the effectiveness.

Methods

• The recruitment constituted individuals living with migraine and/or tension-type headache.
• The interventions included non-pharmacological educational or psychological self-management interventions; with the exclusion of biofeedback and physical therapy.
• The overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption was contemplated.
• Preliminary evidence was yielded on the effectiveness of intervention components and delivery methods.

Results

• A minor overall effect was found for the superiority of self-management interventions over usual care, with a standardised mean difference (SMD) of -0.36 (-0.45 to -0.26) for pain intensity; -0.32 (-0.42 to -0.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (-0.66 to -0.40)).
• There was no effect on headache frequency (SMD=-0.07 (-0.22 to 0.08)).
• The analysis of components and characteristics indicated a larger effect on pain intensity in interventions which encompassed explicit educational components (-0.51 (-0.68 to -0.34) vs -0.28 (-0.40 to -0.16)); mindfulness components (-0.50 (-0.82 to -0.18) vs 0.34 (-0.44 to -0.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (-0.72 to -0.40) vs -0.39 (-0.52 to -0.27)).
• Larger effects were observed on mood, in interventions along with a cognitive-behavioural therapy (CBT) component with an SMD of -0.72 (-0.93 to -0.51) compared with those without CBT -0.41 (-0.58 to -0.24).