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. 2017 Jul 18;89(3):291-301.
doi: 10.1212/WNL.0000000000004112. Epub 2017 Jun 14.

Prognostic factors for chronic headache: A systematic review

Katrin Probyn  1 , Hannah Bowers  2 , Fiona Caldwell  2 , Dipesh Mistry  2 , Martin Underwood  2 , Manjit Matharu  2 , Tamar Pincus  2 ; CHESS Team
Affiliations

Prognostic factors for chronic headache: A systematic review

Katrin Probyn et al. Neurology. .

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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Figures

Figure
Figure. Study flowchart
RCT = randomized controlled trial.
See this image and copyright information in PMC

Comment in

  • Chronic headache: What's in a name?
    Louter MA, Ward TN, Terwindt GM. Louter MA, et al. Neurology. 2017 Jul 18;89(3):224-225. doi: 10.1212/WNL.0000000000004124. Epub 2017 Jun 14. Neurology. 2017. PMID: 28615431 No abstract available.

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