A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. A multicentre European and Latin American study

Jensen, Rigmor; Tassorelli, Cristina; Rossi, Paolo; Allena, Marta; Осипова, В. В.; Steiner, TJ; Sandrini, Giorgio; Olesen, Jes; Nappi, Giuseppe

doi:10.1177/0333102411424212

Cited by 55 publications

(55 citation statements)

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“…In order to counteract this, we will also use headache data from prospective headache diaries [87]. Recent studies using a similar headache diary with written instructions before first consultation found high usefulness, acceptability and comprehensibility of the diary as well as good compliance and completeness of data [105,106]. We will use the headache diary for periods of two weeks.…”

Section: Discussionmentioning

confidence: 99%

Study protocol: Brief intervention for medication overuse headache - A double-blinded cluster randomised parallel controlled trial in primary care

et al. 2012

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BackgroundChronic headache (headache ≥ 15 days/month for at least 3 months) affects 2–5% of the general population. Medication overuse contributes to the problem. Medication-overuse headache (MOH) can be identified by using the Severity of Dependence Scale (SDS). A “brief intervention” scheme (BI) has previously been used for detoxification from drug and alcohol overuse in other settings. Short, unstructured, individualised simple information may also be enough to detoxify a large portion of those with MOH. We have adapted the structured (BI) scheme to be used for MOH in primary care.Methods/DesignA double-blinded cluster randomised parallel controlled trial (RCT) of BI vs. business as usual. Intervention will be performed in primary care by GPs trained in BI. Patients with MOH will be identified through a simple screening questionnaire sent to patients on the GPs lists. The BI method involves an approach for identifying patients with high likelihood of MOH using simple questions about headache frequency and the SDS score. Feedback is given to the individual patient on his/her score and consequences this might have regarding the individual risk of medication overuse contributing to their headache. Finally, advice is given regarding measures to be taken, how the patient should proceed and the possible gains for the patient. The participating patients complete a headache diary and receive a clinical interview and neurological examination by a GP experienced in headache diagnostics three months after the intervention. Primary outcomes are number of headache days and number of medication days per month at 3 months. Secondary outcomes include proportions with 25 and 50% improvement at 3 months and maintenance of improvement and quality of life after 12 months.DiscussionThere is a need for evidence-based and cost-effective strategies for treatment of MOH but so far no consensus has been reached regarding an optimal medication withdrawal method. To our knowledge this is the first RCT of structured non-pharmacological MOH treatment in primary care. Results may hold the potential of offering an instrument for treating MOH patients in the general population by GPs.Trial registrationClinicalTrials.gov identifier: NCT01314768

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Section: Discussionmentioning

confidence: 99%

Study protocol: Brief intervention for medication overuse headache - A double-blinded cluster randomised parallel controlled trial in primary care

et al. 2012

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“…The centers to be invited to participate in the survey were identified from the registries of the two Italian scientific headache societies (ANIRCEF and SISC) [41, 42]. The following requirements had to be satisfied by the centers in order to be eligible for the survey: i) qualification as third-level headache centers (i.e., hospital-based centers in which advanced multidisciplinary care is delivered by headache specialists) [43]; ii) certification of training in the use of OBT-A in CM according to the PREEMPT paradigm obtained after attendance of the specialized courses of Continuing Medical Education delivered in Italy; iii) at least one year of experience in the use of OBT-A for the treatment of CM; and iv) routine use of a headache diary to monitor patients’ symptoms [20, 44]. Care was taken to ensure that the participating centers were located over the entire national territory so as to be representative of clinical practice across the various regions of Italy.…”

Section: Methodsmentioning

confidence: 99%

Onabotulinumtoxin A for the management of chronic migraine in current clinical practice: results of a survey of sixty-three Italian headache centers

et al. 2017

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BackgroundChronic migraine is a complex clinical condition often undertreated. Onabotulinumtoxin A (OBT-A) was approved in Italy in 2013 for symptom relief in patients with chronic migraine who have failed, or do not tolerate, oral prophylactic treatments. However, the impact of OBT-A in clinical practice remains to be defined.MethodsTo investigate the current management of chronic migraine with OBT-A in clinical practice, a web-based survey was conducted among clinicians working in third-level headache centers across Italy. A 26-item questionnaire was designed and developed by a group of 10 Italian headache specialists to address the following issues: treatment paradigm and OBT-A injection intervals, frequency of treatment and retreatment, definition of responders/non-responders, satisfaction with treatment potential impact of early treatment with OBT-A. Ninety-six headache centers were selected and contacted via e-mail. The online survey was anonymous and carried out using a secure website.ResultsOverall, 64 of the 96 centers (66.7%) completed the questionnaire. Most centers (98.4%) had been using OBT-A for >1 year. OBT-A was administered according to the PREEMPT paradigm in most centers (88.9%). While during the first year of prophylaxis with OBT-A most clinicians (93.6%) repeated OBT-A treatment every 3 months, as recommended, in the following years interval duration was variable. Response to OBT-A was defined as a ≥ 50% reduction in the headache days by 58.7% of the clinicians, and as a ≥ 30% reduction by 25.4% of them. Almost 60% of the clinicians considered OBT-A as a long-lasting therapy, while for one-third of them treatment could be discontinued in patients showing a benefit for ≥6 months. According to 80% of the clinicians, early administration of OBT-A after the onset of chronic migraine was associated with better outcomes, and 47.6% felt that OBT-A should be recommended as a first-line option.ConclusionsThis survey indicates that in third-level headache centers in Italy OBT-A is used in good compliance with current recommendations. There is agreement about the definition of response as a reduction in headache days by 30% to 50%. Additional effort is required to define response to OBT-A and to establish optimal treatment duration.

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“…In clinical practice, patient self‐report and diaries are used to identify potential trigger factors or premonitory features and associate them with the headache onset. To facilitate identification of triggers, prodromal features, and clinical symptomology, patients should be encouraged to maintain a headache diary . Useful data elements include headache occurrence; onset and duration; pain intensity (rated on a scale of 0‐10); presence of aura or focal neurological symptoms; associated features; medication use; menstrual cycle; mood ratings; information about sleep; diet including meals; caffeine, alcohol, and nicotine use; weather (with a focus on barometric change); and life events.…”

Section: Self‐predictionmentioning

confidence: 99%

Methodological Issues in Studying Trigger Factors and Premonitory Features of Migraine

et al. 2014

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A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. A multicentre European and Latin American study

Abstract: It is concluded that the BDHD is a useful tool in the diagnostic assessment of the most frequent and disabling forms of primary headache and in headache management.

Cited by 55 publications

References 14 publications

Study protocol: Brief intervention for medication overuse headache - A double-blinded cluster randomised parallel controlled trial in primary care

Study protocol: Brief intervention for medication overuse headache - A double-blinded cluster randomised parallel controlled trial in primary care

Onabotulinumtoxin A for the management of chronic migraine in current clinical practice: results of a survey of sixty-three Italian headache centers

Methodological Issues in Studying Trigger Factors and Premonitory Features of Migraine

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