Multidimensional subgroups in migraine: differential treatment outcome to a pain medicine program.
OBJECTIVE: The present study compared two different approaches for deriving patient profiles on their ability to predict treatment outcome to a pain medicine program for migraine headache. DESIGN/METHODS: Using visual analog scale measures of pain intensity and functional limitations and the Beck De...
| Publicado en: | Pain Medicine Vol. 4; no. 3; pp. 215 - 223 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Sep2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106656307&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106656307 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15262375 FRX jtl: Pain Medicine issn: 15262375 maglogo: N pubinfo: dt: Sep2003 vid: 4 iid: 3 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 106656307 2004170839 10.1046/j.1526-4637.2003.03027.x NLM12974820 106656307 ppf: 215 ppct: 8 formats: tig: atl: Multidimensional subgroups in migraine: differential treatment outcome to a pain medicine program. aug: au: Davis PJ Reeves JL II Graff-Radford SB Hastie BA Naliboff BD affil: UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA sug: subj: Migraine Classification Pain Measurement Migraine Psychosocial Factors Treatment Outcomes Migraine Therapy Visual Analog Scaling Clinical Assessment Tools Psychological Tests Cluster Analysis Data Analysis Software Chi Square Test One-Way Analysis of Variance Adolescence Adult Middle Age Aged Aged, 80 and Over Human Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over ab: OBJECTIVE: The present study compared two different approaches for deriving patient profiles on their ability to predict treatment outcome to a pain medicine program for migraine headache. DESIGN/METHODS: Using visual analog scale measures of pain intensity and functional limitations and the Beck Depression Inventory (BDI), as a measure of depression, 235 migraine patients were classified into statistical clusters. The same patients were also classified using the Multidimensional Pain Inventory (MPI) algorithm into three subgroups: Adaptive copers (AC), characterized by lower reported levels of pain intensity, life interference, and distress, as well as higher levels of perceived life control; interpersonally distressed (ID), characterized by more intermediate levels of pain, distress, and interference, with a predominant perception of inadequate support and punishing responses from significant others; and dysfunctional (Dys), characterized by high levels of pain severity, life interference, and distress and low levels of perceived life control and activity. RESULTS: The results of the K-cluster analysis yielded a three-cluster solution: The low impact cluster, was characterized by low pain, low functional limitations and low depression and showed significant reductions in pre-to-posttreatment pain; the moderate impact cluster displayed higher levels of pain and functional limitations and low depression and showed only slight pre-to-posttreatment pain reduction; and the high impact cluster displayed the highest levels of pain, functional limitations, and depression and showed significant increases in pre-to-posttreatment pain. Unlike the K-clustered groups, MPI subgroups failed to differentially predict treatment outcome. When the K-clustered groups were crosstabulated with the MPI subgroups, the predictive validity of the MPI subgroups was enhanced. CONCLUSION: This study questions the validity of the MPI subgroup classification algorithm. The results indicate that the K-clustering approach is more useful than the MPI in deriving meaningful patient clusters that differentially predict treatment outcome in a migraine population. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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