Effectiveness of behavioural management on migraine in adult patients visiting family practice clinics: a randomized controlled trial

Objectives: To assess the effectiveness of behavioural management in the treatment of migraine among adult patients. Methods: The randomised control trial was conducted from August 2011 to August 2012 at the Aga Khan University Hospital, Karachi, in which adult patients aged 18-65 years were recruited with diagnosis of migraine from five outpatient sites. The patients were randomised into 2 equal groups. The controls were given pharmacological treatment, while the cases were given a structured behavioural management and pharmacological treatment. Primary outcome was the change in frequency of migraine attacks. Secondary outcome included change in severity of migraine and effect on the quality of life. SPSS 19 was used for statistical analysis. Results: Of the 90 subjects in the study, 72(80%) were female. A significant reduction in the average frequency of migraine attacks was observed from baseline up to 4 weeks (p 0.001) but no difference in the mean migraine attacks was observed in the two groups (p 0.945). In the average score of severity of pain, significant reduction was observed for time (p 0.001) as well as for the intervention status (p 0.034). There was no significant difference (p 0.450) between treatment type and duration of migraine, but a significantly better quality of life (p 0.001) was observed in the trial group compared to the controls. Conclusion: There was significant decrease in frequency, severity and duration of migraine attacks in the trial group compared to the control group. The quality of life also showed improvement in the trial group.