Headache Unit, Department of Clinical Neuroscience, C. Besta Neurological Institute and Foundation, Via Celoria, 11, 20133 Milan, Italy.
Neurol Sci. 2013 May;34 Suppl 1:S1-5. doi: 10.1007/s10072-013-1378-9.
Headache disorders determine relevant personal and societal burden, and thus the use of patient-reported outcome measures (PROMs) investigating the level of disability and health-related quality of life (HRQoL) have been increasingly used in headache research. The aim of this review was to address the status of research on disability and HRQoL, by addressing results from recently published clinical trials as well as in longitudinal observational studies on headache patients. PubMed has been searched for papers in which measures of HRQoL and/or disability were used as primary or secondary outcome on adult subjects with primary headache, and published in 2010-2012. Among the 70 records retrieved, 12 papers were selected for narrative synthesis. They included data on 2,621 patients with episodic migraine with and without aura, chronic daily headache, and/or chronic migraine with and without medication overuse. The selected trials investigated the efficacy of different pharmacological prophylaxis, of some surgical approaches, of education programmes and osteopathic manipulative treatment; two studies reported longitudinal observations of patients currently under treatment. Overall, the results of our review showed that headache frequency as well as HRQoL and disability were positively impacted by treatment interventions; positive outcomes were less evident in two studies, and similar results were found in the two observational studies. Our findings confirmed that the most commonly used PROMs, including disease-specific tools to assess disability and HRQoL and SF-36, are sensitive to the beneficial effects occurring over time in functioning and quality of life domains in headache patients. They also suggest that the personal and societal costs of headache disorders are likely to be reduced when headache patients receive appropriate treatments and when continuity of care is offered. In terms of future directions, we note that the systematic use of appropriate PROMs should be encouraged both in the clinical practice and in the research field, as they offer a valid option to assess the global effect of treatments on patient-perceived sense of well-being and quality of performance.
头痛障碍会对个人和社会造成严重负担，因此，使用患者报告的结局测量（PROM）来评估残疾程度和健康相关生活质量（HRQoL）已在头痛研究中得到广泛应用。本综述旨在探讨残疾和 HRQoL 的研究现状，主要分析了近期发表的临床试验以及头痛患者的纵向观察研究结果。我们在 PubMed 上检索了 2010 年至 2012 年期间发表的使用 PROM 作为主要或次要结局指标，评估成年原发性头痛患者的健康相关生活质量和/或残疾的论文。在检索到的 70 篇记录中，有 12 篇论文被选为叙述性综合分析。这些论文的数据来源于有先兆和无先兆的发作性偏头痛、慢性每日头痛、以及/或药物过度使用性慢性偏头痛患者，共涉及 2621 例患者。入选试验评估了不同药物预防、某些手术方法、教育计划和整骨治疗的疗效，有两项研究报告了正在接受治疗的患者的纵向观察结果。总体而言，本综述结果表明，头痛发作频率、HRQoL 和残疾程度会受到治疗干预的积极影响；在两项研究中，积极结果不太明显，而在两项观察性研究中则发现了相似的结果。我们的研究结果证实，最常用的 PROM，包括评估残疾和 HRQoL 的疾病特异性工具以及 SF-36，在头痛患者的功能和生活质量领域随时间推移而产生的有益效果方面是敏感的。研究结果还表明，当头痛患者接受适当的治疗和提供连续性护理时，头痛障碍的个人和社会成本可能会降低。在未来的研究方向上，我们注意到，在临床实践和研究领域中，应鼓励系统地使用适当的 PROM，因为它们为评估治疗对患者感知幸福感和绩效的整体效果提供了一种有效的选择。
