Background: RCM is often associated with disability, and a low quality of life (QOL). Long-term outcomes for RCM patients have not been well studied. There is a need to categorize these points according to severity. We utilized a unique RCM severity rating scale, tracking the clinical course over 10 years.
QOL: The results as of the year 2000, 129 RCM patients were given a severity score (2 to 10). 24 points =mild, 67 moderate, 38 severe. The average QOL for mild patients improved 35% from 2000 to 2008-2010. 66% improved 35% or more. For moderate patients, average QOL improved 32%, while 57% improved 30% or more. In the severe group average quality of life improved 33%, and 61% improved 30% or more. QOL was same, or worse, in 4% of mild patients, 16% of moderate and 18% of severe patients. At the end of the study, QOL levels were still significantly less in the severe group, than the mild or moderate groups.
Pain Level (1-10): For mild patients, pain scores declined over 10 years by average 45%. 80% of mild patients had pain levels decline 30% or more. Moderate, pain declined average of 42%; 72% had pain levels decline 30% or more. In Severe patients, pain declined an average of 36%; 71% had decrease of 30% or more. Pain was same, or worse, in 4% of mild, 15% of moderate, and 18% of severe patients. Pain levels remained higher in the severe group, over the others. ANOVA for pain change scores yielded no difference between groups.
MEDS: Overall, the medications that helped significantly over the 10 years included: opioids(63%), frequent triptans(31%), butalbital(17%), stimulants(12%), and “other” various preventives(9%).
Conclusions: RCM patients were rated using a refractory scale, and their course followed over 10 years. 60% of RCM patients had at least a 30% improvement in QOL, while only 15% remained the same (or declined). 73% had a 30% or more decline in pain level over 10 years. In the severe group, QOL and pain improved, but after 10 years still lagged behind the mild and moderate patients. Opioids and (frequent) triptans were the most commonly utilized medications.

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