Chronic Headache Education and Self-management Study (CHESS) – a mixed method feasibility study to inform the design of a randomised controlled trial
Open accessAbstract
BACKGROUND: Self-management support programmes are effective in a range of chronic conditions however there is limited evidence for their use in the treatment of chronic headaches. The aim of this study was to test the feasibility of four key aspects of a planned, future evaluative trial of a new education and self-management intervention for people with chronic headache: 1) recruiting people with chronic headache from primary care; 2) a telephone interview for the classification of chronic headaches; 3) the education and self-management intervention itself; and 4) the most appropriate patient reported outcomes (PROMS). METHODS: Participants were identified and recruited from general practices in the West Midlands of the UK. We developed a nurse-led chronic headache classification interview and assessed agreement with an interview with headache specialists. We developed and tested a group based education and self-management intervention to assess training and delivery receipt using observation, facilitator, and participant feedback. We explored the acceptability and relevance of PROMs using postal questionnaires, interviews and a smartphone app. RESULTS: Fourteen practices took part in the study and participant recruitment equated to 1.0/1000 registered patients. Challenges to recruitment were identified. We did 107 paired headache classification interviews. The level of agreement between nurse and doctor interviews was very good. We piloted the intervention in four groups with 18 participants. Qualitative feedback from participants and facilitators helped refine the intervention including shortening the overall intervention and increasing the facilitator training time. Participants completed 131 baseline questionnaires, measurement data quality, reliability and validity for headache-specific and generic measures was acceptable. CONCLUSION: This study indicated that recruiting people with chronic headache from primary care is feasible but challenging, our headache classification interview is fit for purpose, our study intervention is viable, and that our choice of outcome measures is acceptable to participants in a future randomised controlled trial (RCT). TRIAL REGISTRATION: ISRCTN, ISRCTN79708100. Registered 16th December 2015, http://www.isrctn.com/ISRCTN79708100.
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In the feasibility study (n=114), the standard deviation of the HIT-6 score at baseline was 6.87.
“In our feasibility study (n=114), the SD of the HIT-6 score at baseline was 6.87.44”
From Usual care and a self-management support programme versus usual care and a relaxation programme for people living with chronic headache disorders: A randomised controlled trial protocol (CHESS) (2020) · cites this paper as [44]
The Methods section says the feasibility study collected HIT-6 scores at baseline, and the Results section reports 131 returned baseline questionnaires. Neither section reports a baseline HIT-6 standard deviation of 6.87 or identifies an n=114 sample for that calculation; the 131 questionnaires do not rule out a smaller subset. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn the feasibility study, around 1/1000 of the practice population were recruited to take part.
“In the feasibility study, we recruited around 1/1000 of practice population to take part44”
In the feasibility study, approximately 95% of recruited participants had chronic migraine and just 5% had chronic tension type headache.
“In the feasibility study, the overwhelming majority of those recruited, approximately 95%, chronic migraine; just 5% had chronic tension type headache.”
From Usual care and a self-management support programme versus usual care and a relaxation programme for people living with chronic headache disorders: A randomised controlled trial protocol (CHESS) (2020) · cites this paper as [44]
The Results section on participant recruitment reports 131 consented participants, and the Results section on classification interviews reports how many interviews were completed, but neither gives the proportions diagnosed with each headache type. The Methods section names chronic migraine and chronic tension-type headache as classification categories; searches for the claimed 95% and 5% breakdown found no corresponding result in our copy. No page numbers were available for these passages. (LLM, conf=0.72)
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On behalf of the CHESS team, Patel, S., Potter, R. C., Matharu, M. S., Carnes, D., Taylor, S. J., Nichols, V. P., Pincus, T., Underwood, M. R., & Sandhu, H. K. (2019) · The Journal of Headache and Pain · doi:10.1186/s10194-019-0980-5 · Cited by 36 · see citing works
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Self-citationChronic Headache Education and Self-Management Study (CHESS): a process evaluation
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Self-citation
- Authors
- on behalf of the CHESS team, White, K., Potter, R., Patel, S., Nichols, V. P., Haywood, K. L., Hee, S. W., Mistry, D., Carnes, D., Taylor, S. J. C., Underwood, M., & Matharu, M. S.
- Affiliations
- University of Warwick (GB)
- Queen Mary University of London (GB)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Potter, Rachel
- ORCID
- Venue
- BMC Medical Research Methodology
- Published
- 2019-02-11
- Volume
- 19
- Issue
- 1
- Pages
- 30-30
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC6371558
- OpenAlex
- W2933589765
- Cited by
- 18
- References
- 34
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 7 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- ArODES (HES-SO (https://www.hes-so.ch/)) (submittedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research (RP-PG-1212-20018)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- chronic headache, self-management, patient education, feasibility, primary care recruitment, telephone interviews, group intervention, patient-reported outcomes, mobile application, intervention development
- MeSH terms
- Patient Reported Outcome Measures, Self-Management, Adult, Feasibility Studies, Female, Humans, Male, Middle Aged, Patient Education as Topic, Pilot Projects, Prospective Studies, Research Design, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Headache Disorders
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