The headache under-response to treatment (HURT) questionnaire, an outcome measure to guide follow-up in primary care: development, psychometric evaluation and assessment of utility

Steiner, Timothy J.; Buse, Dawn C.; Jumah, Mohammed Al; Westergaard, M.; Jensen, Rigmor; Reed, Michael L.; Prilipko, L. L.; Mennini, F.S.; Láinez, Miguel J. A.; Ravishankar, K.; Sakai, Fumihiko; Yu, Songyan; Fontebasso, Manuela; Khathami, A. Al; MacGregor, Anne; Antonaci, Fabio; Tassorelli, Cristina; Lipton, Richard B.

doi:10.1186/s10194-018-0842-6

Cited by 26 publications

(28 citation statements)

References 29 publications

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“…One approach to assessing and optimizing the treatment of headache diseases is the use of headache diaries. In addition, several instruments have been designed to measure optimization of and/or satisfaction with acute and preventive medications (Table ) …”

Section: Discussionmentioning

confidence: 99%

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Lipton

Munjal²,

Buse

et al. 2019

Headache

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Objectives To characterize unmet treatment needs in a sample of Migraine in America Symptoms and Treatment (MAST) Study participants using oral, acute prescription migraine medications. Background The MAST Study is a 2017 study of US adults with migraine that profiles current treatment patterns and identifies and quantifies unmet treatment needs. Methods Cross‐sectional data from an online survey of US adults meeting ICHD‐3 beta criteria for migraine. For inclusion in this paper, respondents self‐reported a history of 3 or more monthly headache days (MHDs) in the past 3 months and at least 1 MHD in the past 30 days, and current use of orally administered acute prescription medication for headache. Three domains of unmet need were identified: inadequate treatment response (ie, inadequate 2‐hour pain freedom, recurrence within 24 hours of initial relief), demanding attack characteristics (rapid onset of attack, headache associated with sleep), and unique patient characteristics (opioid or barbiturate overuse, cardiovascular comorbidity). Sociodemographics, oral medication use, and coexisting conditions and symptoms (ie, level of treatment optimization, psychological symptoms, attack‐related cutaneous allodynia, and migraine symptom severity) were assessed for each domain and by the number of unmet need domains. Results Overall, 15,133 respondents met inclusion criteria, 26.0% (3930/15,133) reported current use of oral acute prescription medication to treat headache. Eligible participants had a mean age of 45.0 years, 73.6% [2892/3930] were women and 81.1% [3186/3930]) were White. A total of 95.8% (3765/3930) of respondents had at least 1 unmet acute treatment need; 89.5% (3516/3930) reported demanding attack characteristics, 74.1% (2912/3930) reported inadequate treatment response, and 16.1% (634/3930) presented with unique patient characteristics. Common areas of unmet need were rapid headache onset (65.3% [2567/3930]), moderate to severe disability (55.6% [2187/3930]), inadequate 2‐hours pain freedom (49.0% [1892/3930]), and headache recurrence within 24 hours (38.0% [1493/3930]). An increasing number of unmet treatment need domains was associated with worsening psychological symptoms, attack‐related cutaneous allodynia and migraine symptom severity. Conclusion Nearly all MAST Study respondents using acute oral prescription medications for migraine reported at least 1 unmet treatment need. As unmet needs increased, so did coexisting conditions and symptom severity.

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Section: Discussionmentioning

confidence: 99%

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Lipton

Munjal²,

Buse

et al. 2019

Headache

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“…HURT has undergone psychometric validation and clinical testing in various settings and cultures [10].…”

Section: Instruments and Other Materials To Aid Diagnosis And Managemmentioning

confidence: 99%

“…Lifting The Burden developed the HURT questionnaire [10] as an instrument that would not only assess outcome but also provide answers to these two questions, offering guidance to non-specialists on appropriate actions towards treatment optimisation.…”

Section: Introductionmentioning

confidence: 99%

Aids to management of headache disorders in primary care (2nd edition)

et al. 2019

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The Aids to Management are a product of the Global Campaign against Headache, a worldwide programme of action conducted in official relations with the World Health Organization. Developed in partnership with the European Headache Federation, they update the first edition published 11 years ago.The common headache disorders (migraine, tension-type headache and medication-overuse headache) are major causes of ill health. They should be managed in primary care, firstly because their management is generally not difficult, and secondly because they are so common. These Aids to Management, with the European principles of management of headache disorders in primary care as the core of their content, combine educational materials with practical management aids. They are supplemented by translation protocols, to ensure that translations are unchanged in meaning from the English-language originals.The Aids to Management may be individually downloaded and, as is the case for all products of the Global Campaign against Headache, are available without restriction for non-commercial use.Electronic supplementary materialThe online version of this article (10.1186/s10194-018-0899-2) contains supplementary material, which is available to authorized users.

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“…Therapeutic response was evaluated in terms of headache frequency, severity, duration, and symptomatic drug consumption. Self-assessment questionnaires, i.e., the Headache Under-Response to Treatment (HURT) (24) and the Migraine Disability Assessment Scale (MIDAS) (25) scales, were also administered to assess disability level and hence the quality of care received.…”

Section: Methodsmentioning

confidence: 99%

Impact of Medical Care on Symptomatic Drug Consumption and Quality of Life in Headache: A One-Year Population Study

et al. 2019

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Background: Chronic headache is one of the most common pain conditions, often leading to symptomatic drug overuse. The aim of this study was to provide data on symptomatic drug consumption in an Italian outpatient population and to describe how the clinical picture of headache may change after headache experts take charge of the care of affected individuals. Methods: A total of 199 adults complaining of chronic headache were recruited through 32 pharmacies in the Pavia health district. Participants underwent four evaluations: a baseline assessment (T0) and three follow-up evaluations performed by a neurologist at 3, 6, and 12 months (T3, T6, and T12, respectively). On each occasion, they underwent a complete neurological assessment and received therapeutic adjustments to achieve better management of their headache. Results: On the basis of a preliminary telephone interview, the prevalence rates of chronic headache and medication overuse headache (MOH) were 16 and 12%, respectively. At 12 months of follow-up, we observed a significant decrease in the frequency of attacks (T0: 9 ± 9/month vs. T12: 2 ± 2/month; p < 0.001), in the number of days/month with headache (T0: 11 ± 9 vs. T12: 4 ± 4; p < 0.001) and in single attack duration (T0: 34 ± 30 h vs. T12: 10 ± 19 h; p < 0.001). Careful headache management resulted in a significant decrease in analgesic consumption (T0: 12 ± 16 vs. T12: 4 ± 6 doses/month; p = 0.014) and a significant increase in quality of life, measured using the Migraine Disability Assessment Scale (MIDAS) and Headache Under-Response to Treatment (HURT) scales ( p < 0.001). Conclusions: Headache management by a specialist is more effective than self-treatment, resulting in an overall benefit for headache patients.

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The headache under-response to treatment (HURT) questionnaire, an outcome measure to guide follow-up in primary care: development, psychometric evaluation and assessment of utility

Cited by 26 publications

References 29 publications

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Aids to management of headache disorders in primary care (2nd edition)

Impact of Medical Care on Symptomatic Drug Consumption and Quality of Life in Headache: A One-Year Population Study

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