Merelle and coworkers evaluated changes at a 6-month follow-up after home-based behavioral training (BT) provided by lay trainers with migraine to small groups of fellow patients. In a previous randomized controlled trial, the authors compared the BT group with a waitlist-control group, receiving usual care. The control group was trained directly after their waitlist period. The present study examined the follow-up results in both groups and measurements were held pre BT, post BT, and at 6-month follow-up. Six months after BT, 42% was categorized as responders, 42% did not change, and 16% responded adversely. In the group as a whole (n = 95), attack frequency significantly decreased from 3.0 attacks at baseline to 2.5 post BT and to 2.3 at 6-month follow-up. The strong improvements of perceived control over and self-confidence in attack prevention were maintained at follow-up. Disability and health status were unchanged but quality of life significantly improved over time. BT was more beneficial for patients who entered the training with a high attack frequency. Linear regression analysis demonstrated that a stronger belief at baseline that the occurrence of migraine is due to chance (external control) significantly predicted a lower attack frequency at follow-up.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: Lay trainers with migraine can train small groups of fellow patients at home in behavioral attack prevention. At 6-month follow-up, attack frequency and quality of life were significantly but modestly improved, and feelings of control and self-confidence remained strongly improved.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Behavioral techniques, particularly those that involve self-management skills, have a strong history (e.g., the research of Ken Holroyd and his colleagues) of helping patients control migraine and other types of headache. If you suffer headaches, you should ask your health care provider to either provide self-management training or refer you to such a program to help you control your condition. You can make a contribution to managing headache.

SY Merelle et al. Lay trainers with migraine for a home-based behavioral training: a 6-month follow-up study. Headache, 2008;48:1311-1325.