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Prognostic factors for chronic headache – a systematic review

Prognostic factors for chronic headache – a systematic review
Prognostic factors for chronic headache – a systematic review


Objective: To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache.

Methods: This was a systematic review of published literature in peer-reviewed journals. We included (1) randomized controlled trials (RCTs) of interventions for chronic headache that reported subgroup analyses and (2) prospective cohort studies, published in English, since 1980. Participants included adults with chronic headache (including chronic headache, chronic migraine, and chronic tension-type headache with or without medication overuse headache). We searched key databases using free text and MeSH terms. Two reviewers independently extracted data and assessed the methodologic quality of studies and overall quality of evidence identified using appropriate published checklists.

Results: We identified 16,556 titles, removed 663 duplicates, and reviewed 199 articles, of which 27 were included in the review—17 prospective cohorts and 10 RCTs with subgroup analyses reported. There was moderate-quality evidence indicating that depression, anxiety, poor sleep and stress, medication overuse, and poor self-efficacy for managing headaches are potential prognostic factors for poor prognosis and unfavorable outcomes from preventive treatment in chronic headache. There was inconclusive evidence about treatment expectations, age, age at onset, body mass index, employment, and several headache features.

Conclusions: This review identified several potential predictors of poor prognosis and worse outcome postinterventions in people with chronic headache. The majority of these are modifiable. The findings also highlight the need for more longitudinal high-quality research of prognostic factors in chronic headache.
0028-3878
Probyn, Katrin
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Bowers, Hannah
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Caldwell, Fiona
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Mistry, Dipesh
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Underwood, Martin
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Matharu, Manjit
fce89299-8b6c-403e-8835-565eecc61b8b
Pincus, Tamar
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Probyn, Katrin
2604caf4-b2bf-4f9e-a19f-16046cb6e4e4
Bowers, Hannah
c81d418d-3cd7-4da5-bd09-0eee862bd49f
Caldwell, Fiona
fe85b24d-112e-46bc-a1f3-efdd267d6d92
Mistry, Dipesh
a8bdb6a9-78fd-429e-b7c5-7a4aa3fd5ab6
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Matharu, Manjit
fce89299-8b6c-403e-8835-565eecc61b8b
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c

Probyn, Katrin, Bowers, Hannah, Caldwell, Fiona, Mistry, Dipesh, Underwood, Martin, Matharu, Manjit and Pincus, Tamar (2017) Prognostic factors for chronic headache – a systematic review. Neurology. (doi:10.1212/WNL.0000000000004112).

Record type: Review

Abstract



Objective: To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache.

Methods: This was a systematic review of published literature in peer-reviewed journals. We included (1) randomized controlled trials (RCTs) of interventions for chronic headache that reported subgroup analyses and (2) prospective cohort studies, published in English, since 1980. Participants included adults with chronic headache (including chronic headache, chronic migraine, and chronic tension-type headache with or without medication overuse headache). We searched key databases using free text and MeSH terms. Two reviewers independently extracted data and assessed the methodologic quality of studies and overall quality of evidence identified using appropriate published checklists.

Results: We identified 16,556 titles, removed 663 duplicates, and reviewed 199 articles, of which 27 were included in the review—17 prospective cohorts and 10 RCTs with subgroup analyses reported. There was moderate-quality evidence indicating that depression, anxiety, poor sleep and stress, medication overuse, and poor self-efficacy for managing headaches are potential prognostic factors for poor prognosis and unfavorable outcomes from preventive treatment in chronic headache. There was inconclusive evidence about treatment expectations, age, age at onset, body mass index, employment, and several headache features.

Conclusions: This review identified several potential predictors of poor prognosis and worse outcome postinterventions in people with chronic headache. The majority of these are modifiable. The findings also highlight the need for more longitudinal high-quality research of prognostic factors in chronic headache.

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Neurology-2017-Probyn-WNL.0000000000004112 - Version of Record
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More information

Accepted/In Press date: 15 March 2017
e-pub ahead of print date: 14 June 2017

Identifiers

Local EPrints ID: 413559
URI: http://eprints.soton.ac.uk/id/eprint/413559
ISSN: 0028-3878
PURE UUID: 21d90e42-3c82-4fcb-b76d-f82adfd4ef79
ORCID for Hannah Bowers: ORCID iD orcid.org/0000-0002-1996-6652
ORCID for Tamar Pincus: ORCID iD orcid.org/0000-0002-3172-5624

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Date deposited: 25 Aug 2017 16:31
Last modified: 12 Jun 2024 02:05

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Contributors

Author: Katrin Probyn
Author: Hannah Bowers ORCID iD
Author: Fiona Caldwell
Author: Dipesh Mistry
Author: Martin Underwood
Author: Manjit Matharu
Author: Tamar Pincus ORCID iD

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