Patients educate patients to control migraine

By Joene Hendry

NEW YORK (Reuters Health) - When migraine patients trained other migraine patients how to prevent migraine headaches, attacks declined and both trainers and trainees gained a greater sense of control over their attacks, researchers report.

Patient-trainers provide credible and recognizable disease-specific knowledge, Dr. Jan Passchier told Reuters Health. "Trainees appreciated the trainers' emotional and motivational assistance."

Moreover, trainers themselves benefited "in terms of large headache improvements and improved quality of life," noted Passchier, of Erasmus University Medical Centre in Rotterdam, the Netherlands.

Passchier and colleagues evaluated the effects of migraine sufferers providing other migraine sufferers with home-based behavior training. Both trainers and trainees were under medical care for relatively frequent migraine (1 to 6 times per month), with or without aura, but had no underlying associated disease, the investigators explain in the journal Cephalalgia.

Passchier's team recruited trainers from a pool of patients who took behavioral training classes themselves. The 14 trainers were educated in how to train others to detect and modify their individual migraine triggers and use relaxation and breathing exercises, as well as other behavioral techniques to prevent attacks.

The investigators then had 60 adult migraine patients participate in seven 2-hour sessions taught by the patient-trainers. Another 67 migraine patients, placed on a waiting list for similar training, served as control group.

The 10-week intervention resulted in a non-significant decline in migraine frequency of 3.1 to 2.4 attacks per month among the 51 patients who completed the intervention, compared with a decline of 3.1 to 2.9 monthly attacks among 57 patients remaining on the wait-list.

Patients reporting greater numbers of migraines appeared to benefit more from training than did those with less frequent attacks, the researchers report.

Moreover, patients receiving behavioral training reported significantly increased self-confidence in their own ability to prevent migraine attacks, and a greater ability to manage and control attacks.

SOURCE: Cephalalgia, February 2008