A meta‐analytic review of acceptance‐based interventions for migraine

Abstract

AbstractObjectiveTo determine the efficacy of acceptance and mindfulness‐based interventions on migraine disability, medication use, and attack frequency.BackgroundAcceptance‐based approaches to headache management are those in which individuals learn to mitigate the influence of pain‐related experiences on their general functioning without controlling pain itself. Treatment approaches include acceptance and commitment therapy (ACT) and mindfulness‐based practices. Both have shown promise in improving broad functioning and disability among individuals with headache. Despite a growing body of research examining acceptance‐based interventions for headache broadly and migraine specifically, no meta‐analytic review of ACT interventions for headache exists, and two meta‐analytic reviews of mindfulness‐based practices yielded conflicting results.MethodsThe present study aimed to systematically and quantitatively review the literature related to the efficacy of acceptance‐based interventions among adults with migraine. A multi‐database search (PubMed/MEDLINE, Scopus, PsycINFO, and the Cochrane Central Register of Controlled Trials) identified clinical trials among individuals with migraine that compared structured ACT or mindfulness‐based interventions to control treatment. Random‐effects meta‐analyses were performed using RevMan 5.4 meta‐analytic software, and standardized mean differences (SMD) with 95% confidence intervals (CIs) quantified effect sizes on outcomes of disability, medication use, and headache frequency. Heterogeneity was quantified via I2 index and explored via subgroup analyses.ResultsAcceptance‐based interventions yielded significant improvements in disability (SMD = −0.38, 95% CI = −0.56 to −0.20; I2 = 25%, p = 0.20) but not in medication use (SMD = −0.25, 95% CI: −0.57 to 0.06; I2 = 0%, p = 0.82) or headache frequency (SMD = −0.16, 95% CI = −0.37 to 0.05; I2 = 0%, p = 0.73).ConclusionResults suggest that acceptance‐based interventions are effective in improving disability among adults with migraine and are a viable non‐pharmacological treatment option, in addition to well‐established behavioral migraine management approaches, for patients seeking functional improvement.