The Role of Minimal- and No-Contact Behavioural Treatments in Migraine: A Review of Efficacy and Cost Effectiveness
The impact of migraine is substantial for both the individual who suffers from it and society in general in terms of lost work hours, medication costs and healthcare usage. Many different forms of treatment are available for migraine, including biobehavioural approaches such as relaxation training and biofeedback. Research regarding the efficacy of these nonpharmacological treatments has been extensive and consistently demonstrates lasting success with the use of the skills taught in treatment. Such treatment approaches have demonstrated effectiveness even when delivered in as few as 2 or 3 sessions with a therapist, thus substantially reducing the cost of treatment. Other treatment formats such as group and no-contact therapies have demonstrated success as well. This article reviews the efficacy and cost efficiency of minimal-contact biobehavioural treatments for migraine as outlined in the research literature. Strictly self-help approaches are also reviewed, and resources for self-help information are discussed. The research indicates that such time-limited and focused treatment approaches are highly effective with select patients; however, there is a lack of research specifying the specific types of patients with migraine who benefit the most from these approaches. Future research needs to address this issue in order to provide the most efficacious and cost-effective treatments for all patients with migraine.
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