Measuring health-related quality of life in chronic headache: a comparative evaluation of the Chronic Headache Quality of Life Questionnaire and Headache Impact Test (HIT-6)

Kirstie L Haywood, Felix Achana, Vivien Nichols, Gemma Pearce, Barbara Box, Lynne Muldoon, Shilpa Patel, Frances Griffiths, Kimberly Stewart, Martin Underwood, Manjit M Matharu

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    Abstract

    Objective: To compare the quality and acceptability of a new headache-specific patient-reported measure the Chronic Headache Quality of Life Questionnaire (CHQLQ), with the Headache Impact Test–6 item (HIT-6), in people meeting an epidemiological definition of chronic headaches.
    Methods: Participants in the feasibility stage of the Chronic Headache Education and Self-management Study (CHESS) (N=130) completed measures three times during a 12-week prospective cohort study. Data quality, measurement acceptability, reliability, validity, responsiveness to change, and score interpretation were determined. Semi-structured cognitive interviews explored measurement relevance, acceptability, clarity, and comprehensiveness.
    Results: Both measures were well completed with few missing items. The CHQLQ’s inclusion of emotional wellbeing items increased its relevance to participant’s experience of chronic headache. End effects were present at item level only for both measures. Structural assessment supported the three and one-factor solutions of the CHQLQ and HIT-6, respectively. Both the CHQLQ (range 0.87 to 0.94) and HIT-6 (0.90) were internally consistent, with acceptable temporal stability over 2-weeks (CHQLQ range 0.74 to 0.80; HIT-6 0.86). Both measures responded to change in headache-specific health at 12-weeks (CHQLQ smallest detectable change (improvement) range 3 to 5; HIT-6 2.1).
    Conclusions: While both measures are structurally valid, internally consistent, temporally stable and responsive to change, the CHQLQ has greater relevance to the patient experience of chronic headache.
    Original languageEnglish
    Pages (from-to)1100-1123
    Number of pages24
    JournalCephalalgia
    Volume41
    Issue number10
    Early online date4 May 2021
    DOIs
    Publication statusPublished - Sept 2021

    Bibliographical note

    This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

    Keywords

    • Headache Impact Test
    • chronic headache
    • outcome measures
    • psychometric evaluation
    • quality of life

    ASJC Scopus subject areas

    • Clinical Neurology

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