This is the first book devoted to the study of the social and economic consequences of headache. Reducing the Burden of Headache analyses the financial cost of headache diseases, the disability and suffering they cause and the impact they have on the quality of life of the sufferers and their families. These are issues of major importance; migraine appears in the top 20 list of diseases ranked according to years lived with disability. Headache, in general, is thought to account for approximately 20% of all days lost from work. Of even greater importance is the impact on everyday life, studies have shown that migraine has a greater impact on the quality of life of sufferers than many other diseases generally considered to be more serious. This book describes and analyses the epidemiological data accumulated in the field and suggests guidelines and interventions aimed at improving healthcare for headache. Adoption of these suggestions combined with judicious use of existing resources and modern treatment options can lead to great improvements in the lives of headache sufferers world-wide.
This book will be of interest to neurologists, general practitioners, epidemiologists, public health specialists, health service managers and all those interested in improving services and outcomes for sufferers of headache.
SECTION I - HEADACHE-RELATED DISABILITY ; 1. Overview of headache prevalence, burden and management ; 2. Measuring headache disability ; 3. Benefits of treatment on headache disability - a personal view on selected data ; 4. Comparing disability and psychological factors in migraine and transformed migraine ; 5. Cognitive efficiency following migraine therapy ; 6. Comparative evolution of MIDAS score after monotherapy with triptans ; 7. Disability-adjusted life years (DALYs) and MIDAS in Japan ; 8. Disability in German headache sufferers: evaluation of a German headache disability inventory ; 9. MIDAS as a tool for monitoring the benefits of treatment strategies over time ; 10. The MIDAS questionnaire in children and young adolescents with headache: a pilot study ; 11. Relationship between disability and quality of life in migraine ; 12. Migraine in France in 2000: epidemiological data ; 13. Validation of the Headache Impact Test (TM) using patient-reported symptoms and headache severity ; 14. Headache-related disability: discussion summary ; SECTION II - PATIENT-CENTRED MEASURES: HEALTH-RELATED QUALITY OF LIFE ; 15. Measuring health-related quality of life: general principles ; 16. Effect of headache on quality of life ; 17. Assessment of the responsiveness of the Migraine-Specific Quality of Life Questionnaire (version 2.1) ; 18. Comparison of the impact of eletriptan versus sumatriptan on migraine-specific quality of life ; 19. Impact of cluster headache on health-related quality of life ; 20. Improvement in migraine-specific quality of life with eletriptan (Relpax (TM)) as compared to Cafergot (R) ; 21. Improvements in health-related quality of life with long-term use of sumatriptan therapy for migraine ; 22. Psychometric evaluation of a computerised program to assess migraine-specific quality of life in clinical practice ; 23. Quality of life and disability in transformed migraine with drug overuse ; 24. Quality of life and migraine: a multicentre Spanish study ; 25. Patient-centred measures: health-related quality of life: discussion summary ; SECTION III - FAMILY BURDEN, COMORBIDITIES AND HEALTH-CARE UTILIZATION ; 26. Family impact of migraine ; 27. Migraine comorbidity with stroke, epilepsy and major depression ; 28. Health care utilization for headache ; 29. Functional improvement in migraine patients treated with oral eletriptan versus sumatriptan: a pooled analysis ; 30. Health-care utilization for in-patient headache therapy ; 31. Self-described 'sinus headache' and headache related impact ; 32. Reducing the personal burden of migraine: a patient's perspective ; 33. The burden of migraine in a sample of doctors of an Italian general hospital in Rome ; 34. The Framig 2000 (II) survey: therapeutical data ; 35. The Framig 2000 (III) survey: health-care use ; 36. Family Burden, comorbidities and health-care utilization: discussion summary ; SECTION IV - ECONOMICS OF HEADACHE ; 37. General principles of disease-costing ; 38. The economic burden of headache ; 39. Measuring the economic benefits of pharmacotherapy: general principles ; 40. Economic cost and benefit of pharmacotherapy for headache ; 41. A stratified approach to migraine management including zolmitriptan is clinically and economically superior to step care approaches: results from the Disability in Strategies of Care (DISC) study ; 42. A comparative study of the effectiveness of eletriptan, Cafergot (R) and sumatriptan in reducing the time loss associated with migraine attacks ; 43. The socio-economic impact of migraine in Spain ; 44. Reductions in medical and pharmacy resource utilization associated with the addition of preventive medication to the migraine management strategy ; 45. Utilization and price differentials of selective 5-HT1-receptor agonists in the European countries ; 46. Regaining time lost during migraine attacks with eletriptan ; 47. Economics of headache: discussion summary ; SECTION V - GUIDELINES AND INTERVENTIONS ; 48. Evidence-based guidelines for migraine headache ; 49. Model interventions to improve headache outcomes in health-care systems ; 50. Model interventions to improve headache outcomes in the workplace ; 51. Analysis of headache patient's behaviour in the pharmacy: results of a French multicentre study ; 52. Comparison of the efficacy of self-medication and medical prescriptions in reducing the burden of headache ; 53. Evaluation of migraine in the workplace ; 54. Headache patient management in 21 Italian headache centres ; 55. Migraine and chronic idiopathic headache in the French workforce: detection and management: the NOEMIE study protocol ; 56. HIT-6 (TM) scores discriminate among headache sufferers differing in headache-associated workplace productivity loss ; 57. Guidelines and interventions: discussion summary ; SECTION VI - IMPROVING HEALTH-CARE SYSTEMS FOR HEADACHE ; 58. Integrating headache services across the primary/secondary care interface ; 59. Comprehensive academic headache centres ; 60. Headache clinic or pain centre: together or separate ; 61. The first year of the Lariboisiere emergency headache centre: a series of 10510 patients ; 62. Headache symptoms and other headache features in non-specified headaches in primary care ; 63. Headache treatment outcome: a proposed paradigm for quantitative anaylsis ; 64. Development of HIT-6 (TM), a paper-based short form for measuring headache impact ; 65. Low socio-economic status is associated with increased risk of frequent headache: a prospective study of 22718 adults in Norway ; 66. Reducing the burden of headache by communicating treatment strategies for employees ; 67. The usefulness of the publication Patient-centred strategies for effective management of migraine, in primary care ; 68. Improving health-care systems for headache: discussion summary