The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Using the Internet to manage headache in children

    The benefits of 2 self-help training programs (multimodal cognitive-behavioral training [CBT] and applied relaxation [AR]) presented via the Internet were compared by researchers from the University of Göttingen, in Germany.

    First, the details.

    • 65 children and adolescents (average age: 13 years) with recurrent headache (at least 2 per month) were assigned to a treatment group.
      • CBT presented via the Internet
      • AR presented via the Internet
      • Educational intervention not involving the Internet
    • Changes in headache frequency, intensity, duration and frequency were recorded.
    • Pain catastrophizing and general well-being (depression, psychopathological symptoms, and health-related quality of life) were also reported.

    And, the results.

    • All groups had a significant reduction in headache frequency, duration, and pain catastrophizing.
    • There were no differences in headache intensity, depression, psychopathological symptoms, or health-related quality of life.
    • Rates of response by the end of treatment were 63% for CBT, 32% with AR, and 19% for educational intervention.
    • Statistical analysis of the results show that it requires 2 people to be treated with CBT for 1 person to benefit, vs 5 for AR and educational intervention.
    • At follow-up, no significant differences were found (CBT: 63%, AR: 56%, educational intervention: 55%).

    The bottom line?

    The abstract is short on details. For example it fails to tell us the duration of treatment and the timing of follow-up.

    That said, in this study, children and adolescents treated with CBT showed improvement in headache frequency, duration, and pain catastrophizing.

    And these results are supported by other studies of Internet-based treatment. Researchers from the Netherlands and Sweden recently conducted a review of 12 studies and concluded, “Internet interventions targeting pain were comparable to the effects found for face-to-face treatments, and the same was true for interventions aimed at headache.”

    Offering CBT  through the Internet potentially saves therapist time, reduces waiting-lists, eliminates travel time, and provides an opportunity to reach patients who can’t easily access more traditional forms of treatments. What’s needed is a study to confirm these benefits in order to make the Internet more available as a reimbursed healthcare service.

    4/24/10 17:13 JR

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