https://orcid.org/0000-0001-7647-3259
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Abstract
Background
The aim of the study was to investigate the clinical profile, disease burden, quality of life, and treatment patterns of various headache subtypes.
Method
In this prospective observational study, 815 patients presenting with chief complaints of headache between January 2020 to September 2021 were registered. After a detailed history, clinical examination, and subtyping, they were assessed at baseline with well-validated scales for severity (Visual Analogue Scale-VAS), disability burden (Migraine Disability Assessment- MIDAS), Humanistic burden (Headache Impact Test-HIT-6), and quality of life (World health organization-quality of life-WHO-QoL-8) scores. After initiating adequate management, parameters were reassessed at 3 and 6 months.
Results
549 (67.7%) patients had migraine (395-episodic migraine, 144-chronic migraine), 266 (32.2%) patients had tension-type headache (TTH). Loss of sleep, prolonged working hours, and stress were common triggers. Disease burden, severity, and poor life quality was quite high in migraine patients (76.5% with moderate to severe disability, 61.7% with severe headache at onset, and 72% with poor life quality). All parameters had statistically significant improvement with preventive medication and lifestyle changes.
Conclusion
In our study, we found migraine was the most common primary headache followed by TTH. Migraine patients had more severity, disease burdens, and inferior quality of life at onset compared to other headaches. With early and proper diagnosis as well as preventive treatment (including lifestyle modifications), all parameters could be reversed positively in a brief time. This is the first study on headache burden and its effect on the quality of life in the north Indian population.
Acknowledgements
we appreciate and acknowledge to all our patients for participation is our study. We also like to thank our colleagues who send the patients for participation in this study
Funding
Not applicable.
Availability of data and materials
The datasets used and/or analysed during the present study are available from the corresponding author on reasonable request.
Authors’ contributions
Anand S. Sastry, Anand Kumar: Planning and conception, data collection, writing of initial and final draft. Author 1 and 2 have contributed equally.
Abhishek Pathak, Varun K. Singh, Rameshwar N. Chaurasia, Deepika Joshi: supervision, statistical analysis and final draft editing
Vineeta Singh: Compilation and writing the manuscript
Vijay N. Mishra: Planning, conception, supervision, statistical analysis, final draft editing and manuscript submission
Ethics approval and consent to participate
This study was approved by the Ethics Committee of the Institute of Medical Sciences, BHU.
Dean/2021/EC/2474 dated 15.02.2021, Institute of Medical Sciences, Banaras Hindu University, Varanasi.
Patient consent for publication
Not applicable.
Disclosure statement
No potential conflict of interest was reported by the authors.
Bullet points
In our study population, migraine was the most common subtype of headache with high prevalence in the rural, non-vegetarian, educated, middle-class population, and in housewives and students.
Headache, especially chronic migraine had a significantly social and economic impact, resulting in poor quality of life.
Amitriptyline and propranolol were commonly used prophylaxes.
The study showed that with early and proper diagnosis as well as preventive treatment, (including non-pharmacological), all parameters could be reversed positively in a brief time,
Figure 2. Grades of disability (%) in episodic and chronic migraine.
Figure 1. Flow-chart of depicting registration of headache patients and follow-ups.
Figure 3. Treatment history before the first visit.
Figure 4. Treatment prescribed after 1st visit.
