To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache.
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.
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.
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.
1) UK National Institute for Health and Social Care Excellence (NICE). Chair of Accreditation Advisory Committee 2) UK National Institute for Health and Social Care Excellence (NICE). Chair Headache Guideline Development Group 2010-12
1) UK National Institute for Health Research, PGfAR, RP-PG-1212-20018 Chief investigator 2015-19 2) UK National Institute for Health Research, HTA, 11/31/01 Chief investigator 2014-16 3) UK National Institute for Health Research, HTA, 08/14/41 Co-investigator 2010-18 4) UK National Institute for Health Research, HTA, 3/146/02 Co-investigator 2016-20 5) UK National Institute for Health Research, HS&DR, 15/15/09 co-investigator 2016 -19 6) UK National Institute for Health Research, HS&DR, 13/97/12 co-investigator 2016-18 7) UK National Institute for Health Research, HTA, 14/224/04 co-investigator 2016-2020 8) UK National Institute for Health Research, HTA, 12/196/08 co-investigator 9) Department of Health Policy Research Programme, Infectious Disease Dynamic Modelling in Health Protection Professor Matthew Keeling University of Warwick 01/11/2013 31/10/2018 ?1,225,176 Active 2013 - 18, co-investigator 10) Australian National Health and Medical Research Council, APP1069329 2014 -18 co-investigator
1) Arthritis Research UK RISE Study CO-Investigator 2017- 19
(1) Headache Currents, subeditor, 9 years, (2)Frontiers in Headache Medicine, Member of editorial board, 1 year (3)BMC Neurology, Member of editorial board, 2 year (4) Australian and New Zealand Journal of Psychiatry, Member of editorial board, 5 year (5) Journal of Headache and Pain, Member of editorial board, 5 year
(1) Autonomic Technologies Inc (2) Allergan (3) Medtronic (4) electroCore
National Institute of Health Research, RP-PG -1212-200018, collaborator, 2 years
Eurospine- Grant to study reassurance in LBP ?62K, Grant number 2016-1. Arthritis Research UK- as Co-applicant on study of return to work in LBP- ?40K. Grant number 21320. Rosetrees Trust- Grant to study building AI systems to recognise unhealthy movements in LBP, ?16K, Grant number A509 M357
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Coinvestigators are listed at Neurology.org.
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