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        New Message Board Archives >> Jan-Mar 2004 >>  Poor Health-Related Quality of Life'  
        
(Message started by: Svenn on Mar 10^th, 2004, 5:19pm)

Title: Poor Health-Related Quality of Life'
Post by Svenn on Mar 10^th, 2004, 5:19pm

From the same site folks http://www.w-h-a.org

'Cluster Headache and Migraine Result in Equally Poor Health-Related Quality of Life'

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The quality of life of cluster headache (CH) sufferers is significantly impaired, at least as severely as migraine sufferers, according to a study published in the February 2004 issue of Cephalalgia.

While the health-related quality of life (HRQoL) has been widely studied in migraine and chronic headache, the effects of CH have largely been overlooked. This study aims to assess the overall health-related quality of life in patients suffering from episodic CH.

Characteristics of Cluster Headache
CH is characterized by recurrent cluster periods of severe one-sided headache, occurring in clusters of seven days to one year, with periods of remission of more than 14 days up to months or years, and occasional shorter periods.

This type of headache has also been called "suicide headache" or "ice-pick headache" due to the excruciating stabbing pain felt in the eyeball area of the sufferer. Tearing of the eye and a blocked or runny nose are common symptoms. The stabbing, often excruciating pain can disrupt daytime work and leisure, and nighttime occurrence can lead to loss of sleep and significantly reduced ability to function.

CH affects more males than females, although female prevalence is rising. CH is a very rare disorder, affecting approximately 0.1 to 0.4% of the general population. Prevalence in children is approximately 0.03% and CH onset usually begins at 27-31 years in both men and women, approximately 10 years later than that of migraine.

Neurologist Csaba Ertsey of Semmelweis University in Budapest, Hungary, and colleagues, enrolled 35 outpatients who fulfilled the International Headache Society criteria of episodic CH. Patients were initially asked to complete a questionnaire, were followed up 3 months later for a telephone interview, and then were again asked to complete a follow-up questionnaire. The results were compared with a group of 53 migraineurs, and 62 individuals from the general population who did not have migraine, cluster or daily headaches.

Measurement Instruments Used
The researchers used the Hungarian versions of two quality of life instruments: the health-related quality of life SF-36, and MSQ version 2.1, a headache-sensitive instrument originally devised for assessing HRQoL in migraine. The instruments were used to measure eight health concepts, including physical functioning, bodily pain, general health, and social functioning. While the instruments include eight of the most frequently measured health concepts, they do not include several important ones including sleep adequacy, cognitive functioning, sexual functioning, and self esteem. Nevertheless Dr. Ertsey and colleagues found them to be a reliable and useful means of studying the functioning and well-being of patients, verified by numerous other studies.1

Results
Compared to the migraine and headache-free control group, there was no significant differences in disease duration and percentage of sumatriptan users in the CH and migraine groups. There were significantly more depressed patients and fewer hypertensive patients in the group of migraineurs. The disease profile of the CH and headache-free groups were similar.

During the cluster period, CH patients had lower QOL scores in all areas compared with non-migrainous controls. CH patients scored significantly lower than migraineurs in bodily pain and social functioning. After the cluster period had ended, CH patient’s scores significantly improved in the role physical functioning, bodily pain and social functioning areas. Vitality and mental health scores also tended to improve. There was no statistical difference between CH patients after the cluster period had subsided and the headache-free controls.

Dr. Ertsey concludes that the study "further demonstrates that CH severely affects the sufferer’s functioning and well-being during the active period. The limitations are at least as severe as those caused by migraine." Furthermore, the limitations "are probably more severe than in a number of important conditions." She stresses that early diagnosis, as well as adequate acute and preventive treatment measures, are essential factors in reducing this burden.

References:
1. Ware JE Jr. SF-36 Health Survey update [www.sf-36.org/tools/SF36bookchapter.shtml 2003.]

Source:
Ertsey C, Bozsik G, Jelencsik JA, Jelencsik I. Health-related and condition-specific quality of life in episodic cluster headache. Cephalalgia 2004;24:188-196.

Date: 9/3/2004

Title: Re: Poor Health-Related Quality of Life'
Post by echo on Mar 10^th, 2004, 5:36pm

Thanks for the article Svenn.

Title: Re: Poor Health-Related Quality of Life'
Post by 9erfan on Mar 10^th, 2004, 5:44pm

on 03/10/04 at 17:19:11, Svenn wrote:

The limitations are at least as severe as those caused by migraine."

HA! What a joke!

Sorry, feeling pretty pissy today.

Title: Re: Poor Health-Related Quality of Life'
Post by Charlie on Mar 10^th, 2004, 5:55pm

Thanks Svenn.

At least they try separating clusters from migraines.

No one does it like we do though.

Hope you're sleeping well my friend.

Charlie

Title: Re: Poor Health-Related Quality of Life' &nb
Post by t_h_b on Mar 10^th, 2004, 5:58pm

on 03/10/04 at 17:19:11, Svenn wrote:

Dr. Ertsey concludes that the study "further demonstrates that CH severely affects the sufferer’s functioning and well-being during the active period.

So those of us who are chronic are screwed all the time instead of on a cyclical basis!

It's interesting that CH is worse than migraine but we don't suffer as much depression.

Title: Re: Poor Health-Related Quality of Life'
Post by catlind on Mar 10^th, 2004, 6:04pm

My understanding after corresponding with Dr. Ertsey was that they would be working with the Italians (and were trying to get the NECH and Dr. Rapoport on board) to develop a cluster specific quality of life questionairre.

The MSQ is migraine specific and as stated in the article leaves out many aspects of cluster headaches that are important. They are working to develop one that will address only cluster headaches.

Cat

Title: Re: Poor Health-Related Quality of Life' &nb
Post by Miklos on Mar 11^th, 2004, 11:12am

Thanks for the article. I copied my pharmacy graduate student who had just asked me about quality of life issues.