Quality of outcome in treating patients with chronic headache within a hospital specialized for migraine. A cohort study with one-year follow-up

Aims:To describe characteristics of in-patients with chronic headache syndr omes being treated with complementary methods, short-term effects at time o f discharge as well as long-term effects covering a catamnesis of 1 year. M ethods: The study was designed as a prospective cohort study with outcome m easurements 2 months in advance of admission to the hospital, at admission, and at time of discharge, continued by follow-up queries 2, 6 and 12 month s after discharge from the hospital. The parameters for describing the cour se of headache symptoms were registered by questionnaires and diaries. Duri ng the first 6 months in 1996, a total of 424 consecutive patients with mig raine or tension-type headache at the 'Migrane-Klinik Konigstein' were incl uded. Results: 82.9% of the patients were women, the mean age was 46,3 +/- 13.0 years. The median of the duration of the disease was 23 years, At disc harge from the hospital there was a marked improvement regarding frequency of headache attacks, intensity of headaches, and concomitant symptoms. 60.5 % of the patients were classified as 'responders' 67.5% responded to follow -up questionnaires. With exception of the duration of headache attacks, a s ignificant improvement regarding the 6-month-follow-up compared to base lev el was observed. Intake of drugs could be diminished and quality of life wa s improved. Patients suffering from tension-type headache showed smaller ef fects in general. Conclusions: Taking into account the mean duration of dis ease of more than 20 years the results suggest a clinically relevant succes s from the patients' view regarding the short-term as well as the long-term course. The problem of data loss with follow-up queries and missing compar ative data reduce the conclusiveness of the results.