Effectiveness of Therapeutic Patient Education for Adults with Migraine. A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

• Published in: Pain medicine (Malden, Mass.) Vol. 15; no. 9; pp. 1619 - 1636
• Main Authors: Kindelan‐Calvo, Paula, Gil‐Martínez, Alfonso, Paris‐Alemany, Alba, Pardo‐Montero, Joaquín, Muñoz‐García, Daniel, Angulo‐Díaz‐Parreño, Santiago, La Touche, Roy
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.09.2014
• Subjects: Adaptation, Psychological; Analgesics - therapeutic use; Behavior Therapy; Behavioral Treatment; Biofeedback, Psychology; Combined Modality Therapy; Counseling; Depression - etiology; Depression - therapy; Disability Evaluation; Headache Disability; Headache Frequency; Humans; Meta‐Analysis; Migraine; Migraine Disorders - drug therapy; Migraine Disorders - psychology; Migraine Disorders - therapy; Patient Education as Topic - methods; Quality of Life; Randomized Controlled Trials as Topic - statistics & numerical data; Research Design; Self Efficacy; Systematic Review; Teaching Materials; Therapeutic Education; Treatment Outcome; Behavioral Treatment; Headache Disability; Meta-Analysis; Therapeutic Education; Migraine; Systematic Review; Headache Frequency
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1111/pme.12505

Objective Our aim was to systematically review and meta‐analyze the effectiveness of therapeutic patient education for migraine. Methods A literature search of multiple electronic databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to identify randomized control trials (RCTs) published in the English and Spanish languages up to and including May 2013. Two reviewers independently selected the studies, conducted the quality assessment (Delphi list), and extracted the results. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses method was used throughout the systematic review and meta‐analysis. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated for relevant outcome measures (headache frequency, headache disability, self‐efficacy, depressive symptoms, and quality of life) and pooled in a meta‐analysis using the random effects model. Results Fourteen RCTs were included in the systematic review. Only nine studies were included in the meta‐analysis. The median quality score was 6.14 ± 1.29 (range: 5–9). There was strong‐moderate evidence for intermediate‐term effectiveness of therapeutic patient education on headache frequency (five studies: N = 940, SMD = −0.24, 95% CI of −0.48 to −0.01, P = 0.03), headache disability (four studies: N = 799, SMD = −1.02, 95% CI of −1.95 to −0.08, P = 0.03), and quality of life (three studies: N = 674, SMD = 0.36, 95% CI of 0.05–0.67, P = 0.02). There was no evidence for either short‐term or intermediate‐term effectiveness of therapeutic patient education on self‐efficacy or depressive symptoms. Conclusion This systematic review revealed strong‐moderate evidence for intermediate‐term effectiveness of therapeutic patient education for migraine. Further high‐quality RCTs are required for conclusive determination of its effectiveness.