Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability

Abstract

Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.

Cluster Headache Impact Questionnaire (CHIQ) – a short measure of cluster headache related disability

“…Previous studies have used non-CH-specific questionnaires like HIT-6, MIDAS, HDI or MSQ 2.1 to measure disability in CH patients [ 3 , 4 ]. These studies have shown higher impairment in chronic and active episodic CH patients compared to eCH patients in remission or healthy controls [ 25 – 27 ].…”

“…Although the excruciating character of CH attacks is well known, disability associated with the disorder has only recently come to focus. Due to the lack of CH-specific questionnaires, generic or migraine-specific questionnaires like the Headache Impact Test™ (HIT-6™), Migraine Disability Assessment (MIDAS), SF-12v2® Health Survey (SF-12v2®) or Migraine Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) have mostly been used [ 3 ]. Although these studies have shown reduced quality of life and substantial disability in CH patients, it has been questioned whether CH-specific impairment is adequately captured or rather underestimated by these instruments [ 4 ].…”

Examining the association between traumatic brain injury and headache

“…One of the main implications is that psychiatric conditions should be considered in PTH management to tailor the treatment to patients [49]. Psychiatric disorders can be neglected in managing headaches in TBI patients; however, long-term management of PTH patients needs to consider a biopsychosocial model for patient treatment [195]. Further research is required to understand the neurobiological and neuropathological mechanisms contributing to secondary headaches following TBI and pave the way for more effective, patient-centered treatments.…”

Unmet needs for migraine

“…For many years now, migraine has been positioned among the first places in the unenviable ranking of disability 8,9 , not only in adults but also in adolescents 10 , and the awareness of its importance as a social disease has now been established. Numerous studies on very large patient populations have shown in different geographical areas how the burden of migraine affects these patients widely at all latitudes when evaluated in terms of Health-Related Quality of Life, work productivity, healthcare resource utilization, cost of illness [11][12][13][14][15] .…”