HOME-BASED BEHAVIORAL TREATMENTS FOR CHRONIC BENIGN HEADACHE - A METAANALYSIS OF CONTROLLED TRIALS

Controlled clinical trials have consistently demonstrated that behavio ral treatments for chronic benign headache produce clinically benefici al outcomes both post-treatment and at follow-up. Given these results there is interest in cost-reduction and redesign of these treatments t o improve their accessibility. One promising approach in this regard i s home-based headache treatment. These treatments seek to provide the same amount of treatment as clinic-based treatments; however, some of the material typically presented to the patient by a clinician is pres ented through home-study materials (e.g., manuals, audiotapes). To dat e, the published literature contains 20 controlled clinical trials whi ch have examined the outcomes produced by home-based treatments. This article presents the first comprehensive meta-analysis of these clinic al outcome studies. Results of the quantitative analyses suggest that home-based treatments produce comparable, or with certain outcome meas ures, superior results to clinic-based treatments. Moreover, cost-effe ctiveness scores of home-based treatments were found to be more than f ive times larger than those of clinic-based therapies. Methodological analyses are also presented along with suggestions for future research .