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The effectiveness of educational, behavioural, and cognitive self-management support interventions for chronic migraine: a systematic review

Hailston A, Davies N, Ratna M, Matharu M, Underwood M

Primary health care research & development, 2025

713 participants

Abstract

Abstract Aim: In this systematic review, we identify and critically appraise randomised controlled trials of effectiveness of available educational, behavioural, cognitive, and self-management support interventions for individuals with chronic migraine. Background: Non-pharmacological interventions have the potential to help people living with chronic migraine. Little is known about their true effectiveness. Methods: We searched Cochrane, Embase, Medline, PsychINFO, Scopus, and Web of Science for randomised controlled trials assessing the effectiveness of educational, behavioural, cognitive, and self-management support interventions, compared to usual care, for adults with chronic migraine. Our outcomes of interest were headache frequency, headache-related disability, quality of life, pain intensity, medication consumption, and psychological wellbeing at baseline and follow-up. Findings: We included six randomised controlled trials (713 participants) whose interventions met our inclusion criteria: two educational, two psycho-educational, and two behavioural interventions. Trial heterogeneity precluded statistical pooling. Several small trials reported some between-group differences. One trial (N = 177) found more people had ≥50 reduction in headache frequency at 12 months following a psychological (mindfulness-based) intervention added to acute medication withdrawal in people with medication overuse headache: 43/89 (48%) control vs. 69/88 (78%) intervention, p < 0.001.…

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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 713 participants or records.

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