Background
Methods
Statistics
Results
Episodic | Chronic | Tension-Type | Episodic | Chronic | Cluster | Episodic | Chronic | |||
---|---|---|---|---|---|---|---|---|---|---|
All | Migraine | Migraine | Migraine | Headache (TTH) | TTH | TTH | Headache (CH) | CH | CH | |
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
514 | 372 (72.4) | 220 (42.8) | 152 (29.57) | 107 (20.8) | 25 (4.86) | 82 (15.95) | 35 (6.8) | 14 (2.72) | 21 (4.09) | |
Sex | ||||||||||
Male | 132 (25.7) | 69 (18.5) | 47 (21.4) | 22 (14.5) | 38 (35.5) | 8 (32.0) | 30 (36.6) | 25 (71.4) | 12 (85.7) | 13 (61.9) |
Female | 382 (74.3) | 303 (81.5) | 173 (78.6) | 130 (85.5) | 69 (64.5) | 17 (68.0) | 52 (63.4) | 10 (28.6) | 2 (14.3) | 8 (38.1) |
Age | ||||||||||
Mean (±SD) | 41.71 (12.04) | 40.65 (11.68) | 38.17 (10.97) | 44.23 (11.76) | 44.65 (13.18) | 42.60 (12.65) | 45.28 (13.28) | 43.97 (10.16) | 39.14 (7.0) | 47.19 (10.65) |
< 20 yrs | 8 (1.6) | 7 (1.9) | 6 (2.7) | 1 (0.7) | 1 (0.9) | 0 | 1 (1.2) | 0 | 0 | 0 |
20–39 yrs | 229 (44.6) | 180 (48.4) | 126 (57.3) | 54 (35.5) | 37 (34.6) | 11 (44.0) | 26 (31.7) | 12 (34.3) | 7 (50.0) | 5 (23.8) |
40–60 yrs | 236 (45.9) | 162 (43.6) | 80 (36.4) | 82 (53.9) | 54 (50.5) | 12 (48.0) | 42 (51.2) | 20 (57.1) | 7 (50.0) | 13 (61.9) |
> 60 yrs | 41 (8.0) | 23 (6.2) | 8 (3.6) | 15 (9.9) | 15 (14.0) | 2 (8.00) | 13 (15.9) | 3 (8.6) | 0 | 3 (14.3) |
Education | ||||||||||
1 | 13 (2.5) | 8 (2.1) | 2 (0.9) | 6 (3.9) | 5 (4.7) | 1 (4.0) | 4 (4.9) | 0 | 0 | 0 |
2 | 24 (4.7) | 17 (4.6) | 10 (4.5) | 7 (4.6) | 5 (4.7) | 0 | 5 (6.1) | 2 (5.7) | 0 | 2 (9.5) |
3 | 178 (34.6) | 126 (33.9) | 86 (39.1) | 40 (26.3) | 39 (36.5) | 7 (28.0) | 32 (39.0) | 13 (37.1) | 4 (28.6) | 9 (42.9) |
4 | 14 (2.7) | 12 (3.2) | 8 (3.6) | 4 (2.6) | 2 (1.9) | 1 (4.0) | 1 (1.2) | 0 | 0 | 0 |
5 | 21 (4.1) | 14 (3.8) | 8 (3.6) | 6 (3.9) | 5 (4.7) | 2 (8.0) | 3 (3.7) | 2 (5.7) | 0 | 2 (9.5) |
6 | 231 (44.9) | 178 (47.9) | 94 (42.7) | 84 (55.3) | 40 (37.4) | 14 (56.0) | 26 (31.7) | 13 (37.1) | 6 (42.9) | 7 (33.3) |
7 | 28 (5.4) | 16 (4.3) | 11 (5.00) | 5 (3.3) | 8 (7.5) | 0 | 8 (9.8) | 4 (11.4) | 4 (28.6) | 0 |
8 | 5 (0.97) | 1 (0.3) | 1 (0.5) | 0 | 3 (2.8) | 0 | 3 (3.7) | 1 (2.9) | 0 | 1 (4.8) |
Profession | ||||||||||
0 | 92 (17.9) | 76 (20.4) | 51 (23.2) | 25 (16.4) | 13 (12.1) | 3 (12.0) | 10 (12.2) | 3 (8.6) | 1 (7.1) | 2 (9.5) |
1 | 124 (24.1) | 87 (23.4) | 45 (20.5) | 42 (27.6) | 24 (22.4) | 5 (20.0) | 19 (23.2) | 13 (37.1) | 8 (57.1) | 5 (23.8) |
2 | 39 (7.6) | 26 (7.0) | 12 (5.5) | 14 (9.2) | 10 (9.4) | 2 (8.0) | 8 (9.8) | 3 (8.6) | 1 (7.1) | 2 (9.5) |
3 | 48 (9.3) | 35 (9.4) | 22 (10.0) | 13 (8.6) | 9 (8.4) | 1 (4.0) | 8 (9.8) | 4 (11.4) | 0 | 4 (19.0) |
4 | 109 (21.2) | 86 (23.1) | 58 (26.4) | 28 (18.4) | 17 (15.9) | 6 (24.0) | 11 (13.4) | 6 (17.1) | 2 (14.3) | 4 (19.0) |
5 | 9 (1.8) | 6 (1.6) | 4 (1.8) | 2 (1.3) | 2 (1.9) | 1 (4.0) | 1 (1.2) | 1 (2.9) | 0 | 1 (4.8) |
6 | 5 (1.0) | 1 (0.3) | 1 (0.5) | 0 | 3 (2.8) | 2 (8.0) | 1 (1.2) | 1 (2.9) | 1 (7.) | 0 |
7 | 4 (0.0) | 2 (0.5) | 1 (0.5) | 1 (0.7) | 2 (1.9) | 0 | 2 (2.4) | 0 | 0 | 0 |
8 | 9 (1.8) | 7 (1.9) | 4 (1.8) | 3 (2.0) | 2 (1.9) | 1 (4.0) | 1 (1.2) | 0 | 0 | 0 |
9 | 26 (5.1) | 19 (5.1) | 11 (5.0) | 8 (5.3) | 4 (3.7) | 1 (4.0) | 3 (3.7) | 3 (8.6) | 1 (7.1) | 2 (9.5) |
10 | 49 (9.5) | 27 (7.3) | 11 (5.0) | 16 (10.5) | 21 (19.6) | 3 (12.0) | 18 (22.0) | 1 (2.9) | 0 | 1 (4.8) |
Years with headaches | ||||||||||
< 3 yrs | 86 (16.7) | 48 (12.9) | 36 (16.4) | 12 (7.9) | 34 (31.8) | 11 (44.0) | 23 (28.0) | 4 (11.4) | 4 (28.6) | 0 |
3–5 yrs | 66 (12.8) | 39 (10.5) | 33 (15.0) | 6 (3.9) | 19 (17.8) | 6 (24.0) | 13 (15.9) | 8 (22.9) | 2 (14.3) | 6 (28.6) |
6-10 yrs | 106 (20.6) | 79 (21.2) | 48 (21.8) | 31 (20.4) | 17 (15.9) | 4 (16.0) | 13 (15.9) | 10 (28.6) | 4 (28.6) | 6 (28.6) |
> 10 yrs | 256 (49.8) | 206 (55.4) | 103 (46.8) | 103 (67.8) | 37 (34.6) | 4 (16.0) | 33 (40.2) | 13 (37.1) | 4 (28.6) | 9 (42.9) |
Nocebo | ||||||||||
> 15 | 291 (56.6) | 217 (58.3) | 142 (64.5) | 75 (49.3) | 55 (51.4) | 16 (64.0) | 39 (47.6) | 19 (54.3) | 9 (64.3) | 10 (47.6) |
< 15 | 223 (43.4) | 155 (41.7) | 78 (35.4) | 77 (50.7) | 52 (48.6) | 9 (36.0) | 43 (52.4) | 16 (45.7) | 5 (35.7) | 11 (52.4) |
Episodic | Chronic | Tension-Type | Episodic | Chronic | Cluster | Episodic | Chronic | ||||
---|---|---|---|---|---|---|---|---|---|---|---|
All | Migraine | Migraine | Migraine | Headache (TTH) | TTH | TTH | Headache (CH) | CH | CH | ||
Q No | Question | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) |
Symptomatic treatment | |||||||||||
Q4 | More important is: | ||||||||||
Safety | 88 (17.1) | 60 (16.1) | 38 (17.3) | 22 (14.5) | 22 (20.8) | 7 (28.0) | 15 (18.5) | 6 (17.1) | 4 (28.6) | 2 (9.5) | |
Efficacy | 416 (80.9) | 308 (82.8) | 180 (81.8) | 128 (84.2) | 81 (76.4) | 17 (68.0) | 64 (79.0) | 27 (77.1) | 10 (71.4) | 17 (81.0) | |
Route of administration | 9 (1.8) | 4 (1.1) | 2 (0.9) | 2 (1.3) | 3 (2.8) | 1 (4.0) | 2 (2.5) | 2 (5.7) | 0 | 2 (9.5) | |
Q5 | They prefer to take: | ||||||||||
A pill | 452 (88.1) | 327 (87.9) | 190 (86.4) | 137 (90.1) | 95 (89.6) | 21 (84.0) | 74 (91.4) | 30 (85.7) | 10 (71.4) | 20 (95.2) | |
A suppository | 17 (3.3) | 14 (3.8) | 10 (4.5) | 4 (2.6) | 2 (1.9) | 0 | 2 (2.5) | 1 (2.9) | 0 | 1 (4.8) | |
A nasal sprey | 27 (5.3) | 18 (4.8) | 14 (6.4) | 4 (2.6) | 5 (4.7) | 4 (16.0) | 1 (1.2) | 4 (11.4) | 4 (28.6) | 0 | |
sc injection | 4 (0.8) | 4 (1.1) | 2 (0.9) | 2 (1.3) | 0 | 0 | 0 | 0 | 0 | 0 | |
Im injection | 9 (1.8) | 5 (1.3) | 3 (1.4) | 2 (1.3) | 4 (3.8) | 0 | 4 (4.9) | 0 | 0 | 0 | |
iv injection | 4 (0.8) | 4 (1.1) | 1 (0.5) | 3 (2.0) | 0 | 0 | 0 | 0 | 0 | 0 | |
Q6 | They do not want to take: | ||||||||||
Pill | 11 (2.2) | 6 (1.6) | 6 (2.7) | 0 | 4 (3.8) | 0 | 4 (4.9) | 1 (2.9) | 1 (7.1) | 0 | |
Suppository | 148 (29.0) | 102 (27.6) | 53 (24.1) | 49 (32.7) | 37 (34.9) | 8 (32.0) | 29 (35.8) | 9 (25.7) | 3 (21.4) | 6 (28.6) | |
Nasal sprey | 35 (6.8) | 30 (8.1) | 14 (6.4) | 16 (10.7) | 3 (2.8) | 0 | 3 (3.7) | 2 (5.7) | 0 | 2 (9.5) | |
sc injection | 18 (3.5) | 12 (3.2) | 11 (5.0) | 1 (0.7) | 3 (2.8) | 3 (12.0) | 0 | 3 (8.6) | 1 (7.1) | 2 (9.5) | |
Im injection | 70 (13.7) | 54 (14.6) | 35 (15.9) | 19 (12.7) | 13 (12.3) | 3 (12.0) | 10 (12.3) | 3 (8.6) | 1 (7.1) | 2 (9.5) | |
iv injection | 229 (44.8) | 166 (44.9) | 101 (45.9) | 65 43.3) | 46 (43.4) | 11 (44.0) | 35 (43.2) | 17 (48.6) | 8 (57.1) | 9 (42.9) | |
Q7 | They prefer more: | ||||||||||
Drugs | 168 (32.7) | 120 (32.3) | 83 (37.7) | 37 (24.5) | 37 (34.6) | 7 (28.0) | 30 (36.6) | 11 (31.4) | 5 (35.7) | 6 (28.6) | |
A device | 345 (67.3) | 251 (67.7) | 137 (62.3) | 114 (75.5) | 70 (65.4) | 18 (72.0) | 52 (63.4) | 24 (68.6) | 9 (4.3) | 15 (71.4) | |
Preventive treatment | |||||||||||
Q8 | More important is: | ||||||||||
Safety | 124 (24.1) | 86 (23.1) | 53 (24.1) | 33 (21.7) | 30 (28.0) | 8 (32.0) | 22 (26.8) | 8 (22.9) | 6 (42.9) | 2 (9.5) | |
Efficacy | 372 (72.4) | 271 (72.8) | 158 (71.8) | 113 (74.3) | 74 (69.2) | 16 (64.0) | 58 (70.7) | 27 (77.1) | 8 (57.1) | 19 (90.5) | |
Route of administration | 18 (3.5) | 15 (4.0) | 9 (4.1) | 6 (3.9) | 3 (2.80 | 1 (4.0) | 2 (2.4) | 0 | 0 | 0 | |
Q9 | They prefer to take: | ||||||||||
1 pill/day | 275 (53.8) | 189 (51.1) | 122 (55.5) | 67 (44.7) | 67 (63.2) | 16 (64.0) | 51 (63.0) | 19 (54.3) | 7 (50.0) | 12 (57.1) | |
2 pills/ day | 39 (7.6) | 27 (7.3) | 18 (8.2) | 9 (6.0) | 9 (8.5) | 4 (16.0) | 5 (6.2) | 3 (8.6) | 2 (14.3) | 1 (4.8) | |
3 pills/day | 10 (2.0) | 8 (2.2) | 6 (2.7) | 2 (1.3) | 0 | 0 | 0 | 2 (5.7) | 0 | 2 (9.5) | |
sc injection/ month | 41 (8.0) | 30 (8.1) | 22 (10.0) | 8 (5.3) | 9 (8.5) | 2 (8.0) | 7 (8.6) | 2 (5.7) | 0 | 2 (9.5) | |
iv injection/ month | 16 (3.1) | 14 (3.8) | 9 (4.1) | 5 (3.3) | 1 (0.9) | 0 | 1 (1.2) | 1 (2.9) | 1 (7.1) | 0 | |
sc injection/ 3 month | 68 (13.3) | 55 (14.9) | 27 (12.3) | 28 (18.7) | 9 (8.5) | 0 | 9 (11.1) | 4 (11.4) | 2 (14.3) | 2 (9.5) | |
iv injection/ 3 month | 62 (12.1) | 47 (12.7) | 16 (7.3) | 31 (20.7) | 11 (10.4) | 3 (12.0) | 8 (9.9) | 4 (11.4) | 2 (14.3) | 2 (9.5) | |
Q10 | They do not want to take: | ||||||||||
1 pill/day | 5 (1.0) | 3 (0.8) | 3 (1.4) | 0 | 2 (1.9) | 0 | 2 (2.5) | 0 | 0 | 0 | |
2 pills/ day | 7 (1.4) | 5 (1.4) | 4 (1.8) | 1 (0.7) | 2 (1.9) | 1 (4.0) | 1 (1.2) | 0 | 0 | 0 | |
3 pills/day | 163 (32.0) | 122 (33.1) | 60 (27.3) | 62 (41.6) | 32 (30.2) | 8 (32.0) | 24 (29.6) | 9 (25.7) | 3 (21.4) | 6 (28.6) | |
sc injection/ month | 67 (13.1) | 44 (11.9) | 26 (1.8) | 18 (12.1) | 18 (17.0) | 3 (12.0) | 15 (18.5) | 5 (14.3) | 2 (14.3) | 3 (14.3) | |
iv injection/ month | 196 (38.4) | 146 (39.6) | 101 (45.9) | 45 (30.2) | 42 (39.6) | 11 (44.0) | 31 (38.3) | 8 (22.9) | 3 (21.4) | 5 (23.8) | |
sc injection/ 3 month | 15 (2.9) | 9 (2.4) | 5 (2.3) | 4 (2.7) | 1 (0.9) | 0 | 1 (1.2) | 5 (14.3) | 2 (14.3) | 3 (14.3) | |
iv injection/ 3 month | 57 (11.2) | 40 (10.8) | 21 (9.5) | 19 (12.8) | 9 (8.5) | 2 (8.0) | 7 (8.6) | 8 (22.9) | 4 (28.6) | 4 (19.0) | |
Q11 | They prefer more: | ||||||||||
Drugs | 189 (36.9) | 136 (36.7) | 96 (43.6) | 40 (26.5) | 43 (40.6) | 8 (32.0) | 35 (43.2) | 10 (28.6) | 3 (21.4) | 7 (33.3) | |
A device | 323 (63.1) | 235 (63.3) | 124 (56.4) | 111 (73.5) | 63 (59.4) | 17 (68.0) | 46 (56.8) | 25 (71.4) | 11 (78.6) | 14 (66.7) |
Subgroup analyses
Discussion
Study strengths and limitations
Suggestions for further targeted research
Conclusion
Clinical implications
-
Headache sufferers prefer to use an external device to treat their headaches, both for symptomatic and preventive treatment.
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Regardless of the primary headache disorder they suffer from, patients prefer to use a pill once daily to prevent their headaches rather an injection once a month or every three months.
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Nocebo is very prevalent among headache sufferers and may affect their choices for the treatment.
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Headache health providers should explore personal patients’ preferences before treatment decision-making and manage potential nocebo behaviors.