A randomized controlled trial of an internet-based treatment for chronic headache
A randomized controlled trial of an internet-based treatment for chronic headache
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DOI：
10.1016/j.brat.2004.01.008
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发表时间：
2005-03-01
影响因子：
4.1
通讯作者：
Blanchard, EB
中科院分区：
文献类型：
--
作者：
Devineni, T;Blanchard, EB
慢性头痛在西方国家是一个重大的公共卫生问题。尽管对照试验证明了面对面行为疗法的有效性和成本效益，但大多数头痛患者获得这些治疗的机会有限。利用互联网技术提供行为干预措施有可能覆盖更多的头痛患者并减轻疾病负担。这项随机对照研究评估了一种通过互联网提供的行为疗法，包括渐进性放松、结合自生训练的有限生物反馈以及压力管理，并将其与症状监测等待名单对照组进行比较。治疗导致头痛活动的减少明显大于单独的症状监测。39%的接受治疗的个体在治疗后头痛症状的自我报告测量中显示出临床显著改善。在两个月的随访中，47%的参与者保持了改善。治疗对一般头痛症状和头痛相关的残疾有显著影响。接受治疗的受试者中药物使用在组内减少了35%。该互联网项目比传统临床治疗更省时。治疗和随访的辍学率分别为38.1%和64.8%，这在行为自助研究中是常见的。这种头痛自我管理的方法很有前景；然而，需要解决一些方法学和伦理学方面的挑战。（C）2004爱思唯尔有限公司。保留所有权利。
Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed. (C) 2004 Elsevier Ltd. All rights reserved.