Long-term follow-up of home-based behavioral management training provided by migraine patients

Background: Behavioral migraine approaches are effective in reducing headache attacks. Availability of treatment might be increased by using migraine patients as trainers. Therefore, Mérelle and colleagues developed and evaluated a homebased behavioral management training (BMT) by lay trainers (1). The maintenance of effects at long-term follow-up is studied in the present study. Method: Measurements were taken pre-BMT (T0), post-BMT (T1), at six-month follow-up (T2), and at long-term followup, i.e. two to four years after BMT (T3). Data of 127 participants were analyzed with longitudinal multi-level analyses. Results: Short-term improvements in attack frequency and self-efficacy post-BMTwere maintained at long-term follow-up (dT0-T3=-.34 and dT0-T3=.69, respectively). The level of internal control that increased during BMT decreased from post-BMT to long-term follow-up (d T0-T3=.18). Quality of life and migraine-related disability improved gradually over time (dT0-T3=.45 and dT0-T3=-.26, respectively). Conclusions: Although the results should be interpreted with caution because of the lack of a follow-up control group and the inability to gather information about additional treatments patients may have received during the follow-up period, the findings suggest that lay BMT for migraine may be beneficial over the long term. If so, this could make migraine treatments more widely available.

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