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Sobe H, Richter M, Berner R, von der Hagen M, Hähner A, Röder I, Koch T, Sabatowski R, Klimova A, Gossrau G. Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study. J Headache Pain 2022; 23:109. [PMID: 36008766 PMCID: PMC9404663 DOI: 10.1186/s10194-022-01481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. METHODS One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy. RESULTS Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects. CONCLUSIONS The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion. TRIAL REGISTRATION DRKS00027523, retrospectively registered.
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Affiliation(s)
- Hanna Sobe
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Matthias Richter
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Ingo Röder
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thea Koch
- Department of Anesthesiology and Intensive Care, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rainer Sabatowski
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.,Department of Anesthesiology and Intensive Care, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Anna Klimova
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Gudrun Gossrau
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
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Richter M, Gruhl E, Lautenschläger E, Müller T, Schumann F, Skiera D, Theisinger A, Zimmer U, Berner R, von der Hagen M, Sabatowski R, Hähner A, Gossrau G. [DreKiP - an outpatient treatment program for children and adolescents with headache]. Schmerz 2017; 32:17-29. [PMID: 28956173 DOI: 10.1007/s00482-017-0245-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Headaches are a frequent health problem among children and adolescents. The ocurrence of headaches and the resulting impairments in the quality of life and activities of daily living are modulated by biopsychosocial interactions, which necessitate a complex treatment program. The Dresden Childrens Headache Program (DreKiP) is a multidisciplinary therapy program consisting of eight modules for children and adolescents: education, stress relief, relaxation techniques, physical fitness, climbing therapy, art therapy and sensory training. In addition, there are six modules containing parallel workshops for parents. This outpatient program lasts 2-3 months and is performed parallel to the daily and school routine. Therapy groups consist of 6-8 patients in each age group. In total patients receive 15 h and the parents 7 h of therapy. Concomitant with the program, headache-associated data, such as headache frequency, medication use and school absence are documented. So far 32 children and adolescents in groups of 11, 14-15, 14-16, 17 and 17-18 years old completed the program. Of the 32 patients 19 presented with migraine and tension type headache, 6/32 with migraine and 7/32 with tension type headache only. The median number of headache days was 15 per month and 4 official school absence days per month. Preliminary results 6 months after the end of the therapy program showed reduced frequency of headaches in three quarters of our patients. The headache frequency was reduced from an initial median of 15 days per month to a median of 8 days per month after the program. The multidisciplinary program DreKiP improves the use of therapeutic means in children and adolescents with primary headaches. Children and adolescents with headache-related impairment in activities of daily life in school and leisure times constitute the target group of this therapy.
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Affiliation(s)
- M Richter
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - E Gruhl
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - E Lautenschläger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - T Müller
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - F Schumann
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - D Skiera
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Theisinger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - U Zimmer
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Berner
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - M von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - R Sabatowski
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - A Hähner
- Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - G Gossrau
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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