The Headache Under-Response to Treatment (HURT) questionnaire

Assessment of utility in headache specialist care

Maria L S Westergaard, Timothy J. Steiner, E. Anne MacGregor, Fabio Antonaci, Cristina Tassorelli, Dawn C. Buse, Richard B. Lipton, Rigmor H. Jensen

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The HURT Questionnaire consists of eight questions which the patient answers as a measure of effectiveness of intervention against headache. This first assessment of clinical utility was conducted in headache specialist centres in three countries in order to demonstrate that HURT was responsive to change induced by effective management. We administered HURT on three occasions to 159 consecutive patients seeking non-urgent care from centres in Denmark and the United Kingdom: the first before the initial visit to the centres; the second at the initial visit; and the third when the specialist judged that the best possible outcome had been achieved in each patient. Questionnaires were also answered by 42 patients at initial and final visits to a centre in Italy. Internal consistency reliability was very good (α = 0.85) while test-retest reliability was fair to low (κ = 0.38-0.62 and rs = 0.49-0.76), possibly because headache was unstable prior to start of management. There were significant changes in responses post-intervention compared with baseline (p < 0.01), indicating a favourable outcome overall in up to 77% of patients, and responsiveness to change, but there was no improvement in patients' concerns about side effects of medication (p = 0.18). We conclude that the questionnaire has utility across headache disorders. It can help patients describe headache frequency and headache-attributed disability, medication use/efficacy/tolerability, self-efficacy and knowledge about headache. It may guide physicians in assessment of disability of individual patients, how to proceed with management towards the best possible outcome, and in evaluating the quality of management.

Original languageEnglish (US)
Pages (from-to)245-255
Number of pages11
JournalCephalalgia
Volume33
Issue number4
DOIs
StatePublished - Mar 2013

Fingerprint

Headache
Therapeutics
Surveys and Questionnaires
Headache Disorders
Self Efficacy
Denmark
Reproducibility of Results
Italy
Physicians

Keywords

  • Global Campaign against Headache
  • Headache disorders
  • HURT questionnaire
  • migraine
  • outcome measure
  • tension-type headache

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Westergaard, M. L. S., Steiner, T. J., MacGregor, E. A., Antonaci, F., Tassorelli, C., Buse, D. C., ... Jensen, R. H. (2013). The Headache Under-Response to Treatment (HURT) questionnaire: Assessment of utility in headache specialist care. Cephalalgia, 33(4), 245-255. https://doi.org/10.1177/0333102412469740

The Headache Under-Response to Treatment (HURT) questionnaire : Assessment of utility in headache specialist care. / Westergaard, Maria L S; Steiner, Timothy J.; MacGregor, E. Anne; Antonaci, Fabio; Tassorelli, Cristina; Buse, Dawn C.; Lipton, Richard B.; Jensen, Rigmor H.

In: Cephalalgia, Vol. 33, No. 4, 03.2013, p. 245-255.

Research output: Contribution to journalArticle

Westergaard, MLS, Steiner, TJ, MacGregor, EA, Antonaci, F, Tassorelli, C, Buse, DC, Lipton, RB & Jensen, RH 2013, 'The Headache Under-Response to Treatment (HURT) questionnaire: Assessment of utility in headache specialist care', Cephalalgia, vol. 33, no. 4, pp. 245-255. https://doi.org/10.1177/0333102412469740
Westergaard MLS, Steiner TJ, MacGregor EA, Antonaci F, Tassorelli C, Buse DC et al. The Headache Under-Response to Treatment (HURT) questionnaire: Assessment of utility in headache specialist care. Cephalalgia. 2013 Mar;33(4):245-255. https://doi.org/10.1177/0333102412469740
Westergaard, Maria L S ; Steiner, Timothy J. ; MacGregor, E. Anne ; Antonaci, Fabio ; Tassorelli, Cristina ; Buse, Dawn C. ; Lipton, Richard B. ; Jensen, Rigmor H. / The Headache Under-Response to Treatment (HURT) questionnaire : Assessment of utility in headache specialist care. In: Cephalalgia. 2013 ; Vol. 33, No. 4. pp. 245-255.
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