Louise Schlosser Mose1, Rigmor Højland Jensen2, Niels-Peter Brøchner Nygaard3, Susanne Schmidt Pedersen4, Bibi Gram5. 1. Department of Neurology, University hospital of Southern Denmark, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark; Research Unit of Health Sciences, University hospital of Southern Denmark, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark. 2. Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark. 3. Research Unit of Health Sciences, University hospital of Southern Denmark, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark; Department of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark. 4. Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark; Department of Cardiology, Odense University Hospital, Winsløws vej 4, 5000 Odense, Denmark. 5. Research Unit of Health Sciences, University hospital of Southern Denmark, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark; Department of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark. Electronic address: bgram@health.sdu.dk.
Abstract
OBJECTIVES: Use of Motivational Interviewing (MI) in education may improve medication-overuse headache (MOH) patients' ability to cope with pain. In a randomised controlled trial, we evaluated the effect of education focusing on behavioural change among MOH patients. METHODS: Ninety-eight MOH patients were randomized (1:1) to standard treatment and 12-weeks of MI-based education versus standard treatment alone after detoxification. Outcome of interest was changes in coping strategies measured by the Coping Strategy Questionnaire at four- and nine months. RESULTS: The educational program improved patients' perceived efficacy in the use of their coping strategies to control pain, both at four-and nine months follow-up (mean±SE): ∆:0.84 ± 0.35, 95% CI:0.16;1.52, p = 0.02 and: ∆: 0.90 ± 0.39, 95% CI:0.14;1.66, p = 0.02, respectively. No between-group differences were detected in the other coping subscales. Within the intervention group, the coping strategy subscales Catastrophizing, and Reinterpretation of pain sensation were significantly improved at nine months follow-up (p = 0.003 vs. p = 0.012, respectively). No changes were found in the control group. CONCLUSION: MI-based education focused on behavioural changes improved MOH patients' perceived efficacy in the use of their coping strategies to control pain. PRACTICE IMPLICATIONS: Education based on MI could be valuable for MOH patients with respect to behavioural changes and perceived headache control.
OBJECTIVES: Use of Motivational Interviewing (MI) in education may improve medication-overuse headache (MOH) patients' ability to cope with pain. In a randomised controlled trial, we evaluated the effect of education focusing on behavioural change among MOH patients. METHODS: Ninety-eight MOH patients were randomized (1:1) to standard treatment and 12-weeks of MI-based education versus standard treatment alone after detoxification. Outcome of interest was changes in coping strategies measured by the Coping Strategy Questionnaire at four- and nine months. RESULTS: The educational program improved patients' perceived efficacy in the use of their coping strategies to control pain, both at four-and nine months follow-up (mean±SE): ∆:0.84 ± 0.35, 95% CI:0.16;1.52, p = 0.02 and: ∆: 0.90 ± 0.39, 95% CI:0.14;1.66, p = 0.02, respectively. No between-group differences were detected in the other coping subscales. Within the intervention group, the coping strategy subscales Catastrophizing, and Reinterpretation of pain sensation were significantly improved at nine months follow-up (p = 0.003 vs. p = 0.012, respectively). No changes were found in the control group. CONCLUSION: MI-based education focused on behavioural changes improved MOH patients' perceived efficacy in the use of their coping strategies to control pain. PRACTICE IMPLICATIONS: Education based on MI could be valuable for MOH patients with respect to behavioural changes and perceived headache control.
Authors: Judith A Pijpers; Dennis A Kies; Erik W van Zwet; Frits R Rosendaal; Gisela M Terwindt Journal: Eur J Neurol Date: 2022-02-10 Impact factor: 6.288