| Author, Year, Followup,a Pain Duration, Study Quality | Intervention | Population | Function and Pain Outcomes | Other Outcomes |
|---|---|---|---|---|
Blanchard, 1990128 1 month Duration of pain: mean 14.2 years Poor | A. Cognitive Stress Coping Training + PMR (n=17): 11, 45-90 minute sessions once or twice per week for 8 weeks B. PMR alone (n=22): 10, 30-70 minute sessions twice weekly for 3 weeks followed by once weekly for 3 weeks with a final session at week 8 C. Pseudomeditation (attention control) (n=19): body awareness and mental control training; 11 sessions over 8 weeks, 40-45 minutes each D. Waitlist (n=19): monitoring via phone, clinical visits and patient diaries. | A vs. B vs. C vs. D Age: 38 vs. 43 vs. 39 vs. 37 years Female: 56% vs. 58% vs. 45% vs. 66% Mean duration of chronicity: 13.0 vs. 13.9 vs. 15.3 vs. 14.3 years Baseline Headache Index Scores: mean 5.82 vs. 5.63 vs. 5.23 vs. 5.05 Baseline Medication Index Scores: mean 39.8 vs. 16.9 vs. 12.1 vs. 24.0 | A vs. C 1 month ≥50% improvement (i.e., reduction) in headache frequency: 62.5% vs. 43.7%; RR 1.43 (95% CI 0.81 to 1.97) Headache Index Scores: 3.2 vs. 4.6; difference −1.4 (95% CI −4.3 to 1.5) A vs. D 1 month ≥50% improvement (i.e., reduction) in headache frequency: 62.5% vs. 20.0%; RR 3.13 (95% CI 0.91 to 2.45) Headache Index Scores: 3.2 vs. 4.5; difference −1.3 (95% CI −3.9 to 1.4) B vs. C 1 month ≥50% improvement (i.e., reduction) in headache frequency: 31.6% vs. 43.7%; RR 0.72 (95% CI 0.65 to 1.69) Headache Index Scores: 3.8 vs. 4.6; difference −0.8 (95% CI −3.2 to 1.6) B vs. D 1 month ≥50% improvement (i.e., reduction) in headache frequency: 31.6% vs. 20%; RR 1.58 (95% CI 0.75 to 2.11) Headache Index Scores: 3.8 vs. 4.5; difference −0.6 (95% CI −2.7 to 1.5) | A vs. C 1 month Medication Index Scores: 20.7 vs. 8.3; difference 12.4 (95% CI −6.8 to 31.6) A vs. D 1 month Medication Index Scores: 20.7 vs. 22.5; difference −1.8 (95% CI −23.8 to 20.2) B vs. C 1 month Medication Index Scores: 9.8 vs. 8.3; difference 1.5 (95% CI −6.8 to 9.8) B vs. D 1 month Medication Index Scores: 9.8 vs. 22.5; difference −12.7 (95% CI −25.6 to 0.21) |
Holroyd, 1991132 1 month Duration of pain: mean 10.7 years Poor | A. CBT (n=19): 3, 1 hour sessions over 8 weeks B. Amitriptyline therapy (n=17): Individualized dosage at 25, 50, or 75 mg/day for 8 weeks | A + B Age: 32.3 years Female: 80% A vs. B Baseline % of Headache-free days: 18.0 vs. 18.5 Baseline Headache Index scores (0−10): 2.17 vs. 2.04 Baseline Headache Pain Peak scores (0−10): 6.41 vs. 6.36 | A vs. B 1 month Proportion with >66% reduction in headaches (substantial improvement): 37% vs. 18%; RR 2.09 (95% CI 0.79 to 2.23) Proportion with 33-66% reduction in headaches (moderate improvement): 53% vs. 35%; RR 1.49 (95% CI 0.80 to 2.03) % of Headache-free days: 54.7 vs. 42.3; difference 12.4 (95% CI −8.06 to 32.86) Headache Index scores: 0.96 vs. 1.49; difference −0.53 (95% CI −1.14 to 0.08) Headache Peak scores: 4.33 vs. 4.55; difference −0.22 (95% CI −1.70 to 1.26) | A vs. B 1 month BDI (0-63): 5.16 vs. 5.56; difference −0.4 (95% CI −3.96 to 3.16) STPI Anxiety (20-80): 18.37 vs. 19.06; difference −0.69 (95% CI −3.99 to 2.62) STPI Anger (20-80): 19.47 vs. 17.44; difference 2.03 (95% CI −1.98 to 6.04) WPSI (scale NR): 16.05 vs. 20.50; difference −4.45 95% CI −9.78 to 0.87) Analgesic Tablets: 0.26 vs. 0.82; difference −0.56 (95% CI −1.16 to 0.04) |
Holroyd, 2001129 1 and 6 months Duration of pain: mean 11.8 years Poor | A. Stress Management Therapy + Placebo (n=34): 3, 1 hour sessions B. Placebo (n=26) Treatment Protocol: identical to group C C. Antidepressant Medications (n=44): Low starting dose (12.5 mg/day increased to 25mg, then 50mg) with the possibility to switch to nortriptyline | A vs. B vs. C Age: 37 vs. 38 vs. 36 years Female: 80% vs. 79% vs. 66% Caucasian: 91% vs. 98% vs. 98% Duration of pain: 12.3 vs. 11.1 vs. 11.9 years Headache frequency, days/month: 26.5 vs. 26.1 vs. 25.1 Baseline Headache Index (0−10): 2.8 vs. 2.7 vs. 2.8 Baseline Days/month with at least moderately severe headache (≥5 on 0−10 scale): 13.5 vs. 13.5 vs. 14.1 | A vs. B 1 month Days/month with at least moderately severe headache: difference 2.5 (95% CI −0.1 to 5.2) Headache Disability Inventory (0−100): difference 7.3 (95% CI 1.6 to 13.0) Headache Index: difference 0.46 (95% CI 0.02 to 0.89) 6 months Patients who experienced ≥50% reductions in Headache Index Scores: 35% vs. 29%; RR 1.18 (95% CI 0.79 to 1.79) Days/month with at least moderately severe headache: difference 5.1 (95% CI 2.3 to 8.0) Headache Disability Inventory: difference 9.3 (95% CI 3.5 to 15.1) Headache Index: difference 0.79 (95% CI 0.30 to 1.28) A vs. C 1 month Days/month with at least moderately severe headache: difference −3.5 (95% CI −6.1 to −0.9) Headache Disability Inventory: difference 0.1 (95% CI −5.6 to 5.7) Mean Headache Index: difference −0.54 (95% CI −0.97 to −0.012) 6 months Patients who experienced >50% reductions in Headache Index Scores: 35% vs. 38%; RR 0.92 (95% CI 0.71 to 1.54) Days/month with at least moderately severe headache: difference 0.1 (95% CI −2.7 to 2.9) Headache Disability Inventory: difference 2.4 (95% CI −3.3 to 8.0) Headache Index: difference −0.13 (95% CI −0.61 to 0.35) | A vs. B 1 month Weighted analgesic use: difference −1.7 (95% CI −12.0 to 8.6) 6 months Weighted analgesic use: difference 11.8 (95% CI 1.5 to 22.1) A vs. C 1 month Weighted analgesic use: difference −19.4 (95% CI −29.5 to −9.3) 6 months Weighted analgesic use: difference −6.2 (95% CI −16.2 to 3.8) |
Unless otherwise noted, followup time is calculated from the end of the treatment period
From: Results
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