{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:45:03Z","timestamp":1792806303832,"version":"4.5.0"},"reference-count":47,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,6,21]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the effect of non-pharmacological self-management interventions against usual care, and to explore di\ufb00erent components and delivery methods within those interventions<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>People living with migraine and\/or tension-type headache<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Non-pharmacological educational or psychological self-management interventions; excluding biofeedback and physical therapy.<\/jats:p>\n                    <jats:p>We assessed the overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption in meta-analysis.<\/jats:p>\n                    <jats:p>We also provide preliminary evidence on the effectiveness of intervention components and delivery methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found a small overall effect for the superiority of self-management interventions over usual care, with a standardised mean di\ufb00erence (SMD) of \u22120.36 (\u22120.45 to \u22120.26) for pain intensity; \u22120.32 (\u22120.42 to \u22120.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (\u22120.66 to \u22120.40)). We did not find an effect on headache frequency (SMD=\u22120.07 (\u22120.22 to 0.08)).<\/jats:p>\n                    <jats:p>Assessment of components and characteristics suggests a larger effect on pain intensity in interventions that included explicit educational components (\u22120.51 (\u22120.68 to \u22120.34) vs \u22120.28 (\u22120.40 to \u22120.16)); mindfulness components (\u22120.50 (\u22120.82 to \u22120.18) vs 0.34 (\u22120.44 to \u22120.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (\u22120.72 to \u22120.40) vs \u22120.39 (\u22120.52 to \u22120.27)) and larger effects on mood in interventions including a cognitive\u2013behavioural therapy (CBT) component with an SMD of \u22120.72 (\u22120.93 to \u22120.51) compared with those without CBT \u22120.41 (\u22120.58 to \u22120.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall we found that self-management interventions for migraine and tension-type headache are more effective than usual care in reducing pain intensity, mood and headache-related disability, but have no effect on headache frequency. Preliminary findings also suggest that including CBT, mindfulness and educational components in interventions, and delivery in groups may increase effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>PROSPERO 2016:CRD42016041291<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016670","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T20:25:24Z","timestamp":1502483124000},"page":"e016670","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":135,"title":["Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1425-2244","authenticated-orcid":false,"given":"Katrin","family":"Probyn","sequence":"first","affiliation":[{"name":"Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipesh","family":"Mistry","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Caldwell","sequence":"additional","affiliation":[{"name":"Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Underwood","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Patel","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harbinder Kaur","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Warwick Medical School, Warwick University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjit","family":"Matharu","sequence":"additional","affiliation":[{"name":"Headache Group, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Pincus","sequence":"additional","affiliation":[{"name":"Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,8,11]]},"reference":[{"key":"2025121513590446000_7.8.e016670.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17277-2"},{"key":"2025121513590446000_7.8.e016670.2","doi-asserted-by":"crossref","unstructured":"Smitherman TA , Houle DB , Penzien JC , et al . 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