Why HURT? A Review of Clinical Instruments for Headache Management

Abstract

The Global Campaign against Headache, directed by the non-governmental organization Lifting The Burden (LTB) in official relations with the World Health Organization (WHO), aspires to reduce the global burden of headache. Ultimately this calls for improvements in headache management, largely in primary care, where most people with headache receive medical care. In support, LTB is developing a range of headache management aids for primary care. Presently, no single instrument covers the range of assessment and decision-making necessary for successful headache management, and few make the important link between assessment and clinical advice. Expressly to fill this gap, LTB has developed a new instrument: the Headache Under-Response to Treatment (HURT) Questionnaire, an eight-item, self-administered questionnaire addressing headache frequency, disability, medication use and effect, perceptions of headache "control" and knowledge of diagnosis. This instrument is intended not only to evaluate current headache outcomes and assess the need for and response to treatment, but also to provide guidance on appropriate actions towards treatment optimization. The first draft of the HURT was created by an expert consensus group, meeting at WHO headquarters in Geneva, Switzerland. The final version came about through multiple refinements following psychometric testing. Assessment of clinical utility is ongoing in multiple countries.

Headache service quality: evaluation of quality indicators in 14 specialist-care centres

“…WHOQoL or similar (manager + HCPs)10007680405705006320100250I1. Protocol for reporting serious adverse events exists (manager + HCPs)0139060100008325006075100 HCPs Health-care providers, ICHD International Classification of Headache Disorders, HURT Headache Under-Response to Treatment questionnaire [1, 21], HALT Headache-Attributed Lost Time questionnaire [13], WHOQoL World Health Organization Quality of Life questionnaire [9], AV Alexander Vein, U University …”

“…HCPs Health-care providers, ICHD International Classification of Headache Disorders, HURT Headache Under-Response to Treatment questionnaire [1, 21], HALT Headache-Attributed Lost Time questionnaire [13], WHOQoL World Health Organization Quality of Life questionnaire [9], AV Alexander Vein, U University…”

“…Diagnostic diaries, demonstrated to be very valuable both in guiding diagnosis and in setting treatment plans [19], were not universally available. Failure to have and make use of instruments for disability assessment — although disability is a major consequence of headache disorders and a range of well-validated disability instruments exists [1, 9, 12, 17, 21] — appears to be both necessary and easy to remedy. The same may apply to quality-of-life assessment, a problem in almost all centres, although this is more relevant to outcome assessment during follow up than to the formulation of treatment plans at time of presentation.…”

“… HCPs health-care providers, ICHD international classification of headache disorders, HURT headache under-response to treatment questionnaire [1, 21], HALT headache-attributed lost time questionnaire [13], WHOQoL the world health organization quality of life questionnaire [9] a Serious adverse events are those that cause death, are life-threatening, terminate or put at risk a pregnancy, or cause hospitalization, prolonged illness, disability and/or malignancy…”

The psychometric properties of the Comprehensive Headache-related Quality of life Questionnaire (CHQQ) translated to Serbian

“…The patients completed the Serbian version of CHQQ, the Serbian version of the Headache Under-Response to Treatment (HURT) Questionnaire (Buse et al 2012) and the Serbian version of The Migraine Disability Assessment Test (MIDAS) (Stewart et al 2001) in the Health Center, after their encounter with the general practitioners, who administered the questionnaires. After completing the questionnaires, the patients returned them to the general practitioners.…”