Patients’ experiences of a behavioural intervention for migraine headache: a qualitative study

Morgan, Myfanwy; Cousins, Sian; Middleton, Laura; Warriner-Gallyer, Genevieve; Ridsdale, Leone

doi:10.1186/s10194-016-0601-5

Cited by 21 publications

(38 citation statements)

References 27 publications

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“…The study of minimal-contact CBT + RT reported that participants found the relaxation aspects of therapy easier to implement. CBT components of therapy were more challenging to learn and apply in the context of a minimal-contact intervention [44]. Improvements in headache seen in this review in studies using CBT related interventions are less than those reported by Goslin et al [10].…”

Section: Discussionmentioning

confidence: 98%

“…These low intensity interventions demonstrated a modest efficacy in migraine reduction, which is of particular relevance because, such approaches are likely to be less costly, hence, potentially more cost-effective [43]. A recent paper provides some understanding of patients’ views using qualitative methods, with interviews [9, 44]. Combining trial methodology with qualitative methods is recommended by the Medical Research Council, but so far not used in trials of psychological interventions for migraine [45].…”

Section: Discussionmentioning

confidence: 99%

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Psychological interventions for migraine: a systematic review

2016

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Migraine causes major health impairment and disability. Psychological interventions offer an addition to pharmacotherapy but they are not currently recommended by the National Institute of Clinical Excellence (NICE) or available in the National Health Service. We aimed to systematically review evidence on the efficacy of psychological interventions for migraine in adults. A search was done of MEDLINE, psychINFO, http://www.opengrey.eu, the meta-register of controlled trials and bibliographies. Twenty-four papers were included and rated independently by two people using the Yates scale, which has 35 points. Cochrane recommendations are that high quality reports score above the mid-point (18 points). Methods used in 17/24 papers were rated ‘high quality’. However, frequently descriptions of key areas such as randomisation methods were omitted. Eighteen studies measured effects of psychological interventions on headache-related outcomes, fifteen reporting significant improvements, ranging 20–67 %. Interventions also produced improvements in psychological outcomes. Few trials measured or reported improvement in disability or quality of life. We conclude that evidence supports the efficacy of psychological interventions in migraine. Over half of the studies were from the USA, which did not provide universal health care at the time of the study, so it is difficult to generalise results to typical populations in receipt of publically funded health services. We agree with the NICE recommendation that high quality pragmatic randomised controlled trials are needed in the UK.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Psychological interventions for migraine: a systematic review

2016

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“…In fact, chronic headache sufferers face a dilemma in social relationships, about concealing or make evident their disease: if patients conceal their condition they risk carrying the burden of the disease alone, with no social support; on the other hand, making chronic headache visible could result in stigma . Morgan and colleagues underlined that the qualitative method was particularly appropriate to investigate the feelings of the patients with migraine and their expectations toward the therapy, highlighting the importance of a patient‐centered approach to create tailored programs . The meaning of living with migraine was also investigated in a qualitative study by Rutberg and Öhrling.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study On Patients With Chronic Migraine With Medication Overuse Headache: Comparing Frequent And Non‐Frequent Relapsers

Scaratti¹,

Covelli

Guastafierro³

et al. 2018

Headache

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Background It is common clinical experience that, after structured withdrawal, some patients with chronic migraine and medication overuse headache (CM with MOH) are more prone than others to relapse and to be in need of further structured treatments. Our aim was to explore similarities and differences between frequent relapsers (FRs) and non‐frequent relapsers (NFRs) by considering their point of view, perceptions, and perspective of their subjective experience with relapse into CM with MOH. Methods Patients were consecutively recruited on occasion of a structured withdrawal treatment and were interviewed individually about their headache experience and their perspectives on relapse into CM with MOH. We considered FR those patients requiring 2 or more structured withdrawals for MOH within 3 years. A narrative approach with no preconceived coding schemes was employed. To facilitate coding, categorization and organization of data the software QRS NVivo 11.0 was used: themes were defined as common to FR and NFR, or peculiar (by frequency or content) to one of the 2 groups. Results Sixteen patients (13 women; mean age of 53) were interviewed: 7 were classified as FRs. A total of 22 themes emerged from 552 single quotations (the 10 most relevant covered 82% of the entire body of quotations). Four themes were commonly reported by both FR and NFR patients, and 6 were peculiar to one group only. Common aspects included issues connected to the dilemma between disclosing, concealing and the feelings of isolation around MOH, the idea of being addicted to medication, presence of anxiety, and the attempt to use non‐pharmacological therapies as an alternative to medication. Peculiar aspects included causal attribution (FRs attributed headache to uncontrollable factors); future expectations at the time point of withdrawal (FRs were generally resigned); high‐performance functioning (FRs believed they are “forced” to reach high levels of performance as a consequence of others’ inability); coping strategies (FRs tended to “passively accept” problems and showed avoidance‐related behaviors). Moreover, FRs were less frequently aware of their problems and described more frequently depressive symptoms. Conclusions Our results highlight that some differences between FR and NFR patients with CM and MOH exist. Frequent relapsers among patients with CM and MOH reported some important peculiarities of the lived experience of having chronic migraine; clinicians should recognize these psychosocial aspects such as social relationships, future expectations, the experience of illness, medication management, and how the withdrawal experience is regarded, as they may be associated with frequent relapse into MOH.

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“…Data were sparse regarding descriptions of the participants. Only 1 of the 10 reviewed studies reported race of participants, which was mostly white . Few studies appeared to capture data based on the HA treatment clinical practice guidelines.…”

Section: Resultsmentioning

confidence: 99%

Meta‐Synthesis on Migraine Management

Minen¹,

Anglin²,

Boubour

et al. 2017

Headache

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Background.-Migraine is one of the top 10 most disabling conditions among adults worldwide. Most migraine research is quantitative and indicates concerns about medication adherence, stigma, and more. Qualitative studies might reveal an improved understanding of migraine patients' perspectives regarding migraine treatment.Objective.-The aim of this study was to synthesize the qualitative research on migraine patients' perspectives regarding migraine treatment to (a) identify common patterns across various types of migraine treatment studies and (b) inform future research.Methods.-A systematic search for qualitative studies in the HA (HA) literature was conducted in Medline (PubMed), PsycINFO, EMBASE, CINAHL, Web of Science, Joanna Briggs Institute EBP Database, and The Cochrane Library. Search terms (subject headings and keywords) were HA, HA disorders, migraine, qualitative studies, and qualitative research. Qualitative studies were systematically identified by using published qualitative search filters recommended by The InterTASC Information Specialists' Sub-Group (ISSG). The search was limited to English only, peer reviewed publications, and studies published between 1996 and 2016. For screening, additional inclusion criteria were (1) adult migraine patients; (2) must mention treatment in the title or study design of the abstract. Ten studies met the inclusion criteria. The Critical Appraisal Skills Program tool was applied to appraise study quality. Thematic analysis produced the codes and themes. Two authors read articles separately and individually created codes. Code lists were synthesized and themes emerged iteratively from the process.Results.-Study sample sizes ranged from 10 to 33 participants, with our findings representing 161 participants. Data were collected either using interviews or focus groups. The more common methodologies were grounded theory and phenomenology. Few (3) studies described the number of headache (HA) days for inclusion in the study. Eight out of 10 used International Classification of Headache Disorders (ICHD) criteria. Our synthesis produced five major themes. The first theme was "Migraine patients' difficulties with health care utilization," and it included issues surrounding the cost of migraine treatment (seeing providers and prescription medications). The second theme was "Migraine patients' perceived relationships with their providers," which included the role and relationship with the provider, as well as trust in the provider and the providers' knowledge in managing HAs. The third theme was "Thoughts about the various migraine treatments." It was based on patients' comments indicating an aversion to prescription medications, the use of non-pharmacological interventions for treatment, behavioral modification as a form of treatment, and the need for additional treatment options. The fourth and fifth themes were "Understanding diagnosis/triggers" and "Societal implications," respectively. The latter theme included feelings of not being taken seriously and issues surroundin...

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Patients’ experiences of a behavioural intervention for migraine headache: a qualitative study

Cited by 21 publications

References 27 publications

Psychological interventions for migraine: a systematic review

Psychological interventions for migraine: a systematic review

A Qualitative Study On Patients With Chronic Migraine With Medication Overuse Headache: Comparing Frequent And Non‐Frequent Relapsers

Meta‐Synthesis on Migraine Management

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