Abstract
Aim: The aim of this study was to investigate the patients' perspective of migraine and chronic daily headache (CDH) management. Methods: The study used a combination of qualitative (Phase 1) and quantitative methods (Phase 2). Both phases were conducted in the UK in adults (aged 18-65), who suffered either from migraine according to the International Headache Society criteria or from CDH. Phase 1 used semi-structured interviews (n=13) that were analysed according to the grounded theory methodology. Phase 2 was based on a postal survey that was administered to migraine, migraine with aura and CDH patients (n=438), who were members of the Migraine Action Association (UK). Findings: The qualitative findings revealed the patients' decision-making to treat and prevent headaches, their perceptions of headache and headache management and the holistic set of strategies used for headache management. Patients were highly involved in their headache care and perceived themselves as a key resource to management. The survey showed that a high proportion of headache patients use strategies from 4 areas of management including health care consultations, medication use, general management and social support. The survey also showed that the use of some strategies differs between different types of headaches. Overall, it was generally the CDH patients, who were more active in their headache management than migraine and migraine with aura patients, and some of these findings were statistically significant. Conclusion: Both the qualitative and quantitative findings of this study showed the patients' high level of involvement in their headache care. Combining the two methodologies helped to confirm and reinforce the findings. The results of this study can be used to identify headache patients as a key resource to management. Their high level of activity in this study shows the patients' willingness to be involved in their own headache care. However, since headache patients still report considerable suffering, it may be necessary to educate headache patients to maximise the outcome of their management efforts.