Evidence map›Paper›PMID 28801425›Full record

SynthesisBMJ open2017

Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components.

Katrin Probyn, Hannah Bowers, Dipesh Mistry, Fiona Caldwell, Martin Underwood, Shilpa Patel, Harbinder Kaur Sandhu, Manjit Matharu, Tamar Pincus, CHESS team.

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 10 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 10 syntheses or guidelines pooled it, 143 citations in OpenAlex.

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  9. Psychological therapies for the prevention of migraine in adults.The Cochrane database of systematic reviews · 2019
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  11. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Katrin ProbynDepartment of Psychology, Royal Holloway University of London, Egham, Surrey, UK.ORCID http://orcid.org/0000-0003-1425-2244
Hannah BowersDepartment of Psychology, Royal Holloway University of London, Egham, Surrey, UK.
Dipesh MistryClinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK.
Fiona CaldwellDepartment of Psychology, Royal Holloway University of London, Egham, Surrey, UK.
Martin UnderwoodClinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK.
Shilpa PatelClinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK.
Harbinder Kaur SandhuClinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK.
Manjit MatharuHeadache Group, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.
Tamar PincusDepartment of Psychology, Royal Holloway University of London, Egham, Surrey, UK.
CHESS team.
Royal Holloway University of London · GBUniversity of Warwick · GBNational Hospital for Neurology and Neurosurgery · GB

Funding

Department of Health RP-PG-1212-20018
6 · The paper itself

Abstract

objectivesTo assess the effect of non-pharmacological self-management interventions against usual care, and to explore different components and delivery methods within those interventions

participantsPeople living with migraine and/or tension-type headache

interventionsNon-pharmacological educational or psychological self-management interventions; excluding biofeedback and physical therapy.We assessed the overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption in meta-analysis.We also provide preliminary evidence on the effectiveness of intervention components and delivery methods.

resultsWe found a small overall effect for the superiority of self-management interventions over usual care, with a standardised mean difference (SMD) of -0.36 (-0.45 to -0.26) for pain intensity; -0.32 (-0.42 to -0.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (-0.66 to -0.40)). We did not find an effect on headache frequency (SMD=-0.07 (-0.22 to 0.08)).Assessment of components and characteristics suggests a larger effect on pain intensity in interventions that included explicit educational components (-0.51 (-0.68 to -0.34) vs -0.28 (-0.40 to -0.16)); mindfulness components (-0.50 (-0.82 to -0.18) vs 0.34 (-0.44 to -0.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (-0.72 to -0.40) vs -0.39 (-0.52 to -0.27)) and larger effects on mood in interventions including a cognitive-behavioural therapy (CBT) component with an SMD of -0.72 (-0.93 to -0.51) compared with those without CBT -0.41 (-0.58 to -0.24).

conclusionOverall we found that self-management interventions for migraine and tension-type headache are more effective than usual care in reducing pain intensity, mood and headache-related disability, but have no effect on headache frequency. Preliminary findings also suggest that including CBT, mindfulness and educational components in interventions, and delivery in groups may increase effectiveness. TRIAL REGISTRATION NUMBER: PROSPERO 2016:CRD42016041291.

Indexed as

Cognitive Behavioral TherapyMindfulnessPatient Education as TopicSelf-ManagementAffectAnalgesicsChronic PainHeadacheHumansMigraine DisordersPain ManagementPsychotherapy, GroupQuality of LifeTension-Type HeadacheAnalgesicsMigrainePreventive MedicineSelf-helpSelf-management InterventionTension-type Headache

Identifiers

PMID28801425
PMCPMC5629643
OpenAlexW2743939179

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.