When dealing with chronic migraine (CM), it's worth trying a comprehensive personalised treatment that includes cognitive behavioural therapy (CBT) and therapy for comorbid disorders. Objective: to identify predictors of the effectiveness of comprehensive personalised treatment, including CBT, in patients with CM. Material and methods . The study included 100 patients with CM (30 men, 70 women; mean age 34.5±7.4 years). All patients received comprehensive personalised treatment, including CBT, migraine pharmacotherapy, lifestyle recommendations, therapeutic exercises and recommendations for physical activity (in the presence of musculoskeletal pain of other localisation), detoxification therapy (in the presence of druginduced headache), and sleep hygiene (in cases of insomnia). Clinical and psychological indicators were assessed before treatment and at 3, 6, 12, and 18 months of follow-up. Results. At month 3, statistically significant (p<0.05) improvements were achieved: reduction in headache frequency, frequency and number of pain medication (PM) doses, dependence on PM, impact of migraine on daily activities, pain catastrophising, anxiety, depression, severity of insomnia, intensity of pain in other locations, and increased adherence to treatment according to the quantitative assessment of adherence to treatment scale (QAA-25). From the 6th to the 18th month of observation, the trend of improvement in the above indicators continued. Clinical effect (CE) in relation to CM was achieved by 74% of patients at 3 months and 79% at 6 months, and this indicator remained stable at 12 and 18 months of observation. A statistically significant association was established using binary logistic regression at the 3rd and 6th–18th months of observation between CE in relation to CM and the duration of CM up to 24 months, with initial adherence to treatment ≥56% according to QAA-25. Conclusion. Predictors of the effectiveness of comprehensive personalised treatment, including CBT, are a duration of CM up to 24 months and initial adherence to treatment ≥56% according to QAA-25.
Головачева et al. (Sat,) studied this question.