CHRONIC HEADACHE EDUCATION AND SELF-MANAGEMENT STUDY (CHESS)

Problem

Chronic headaches (headaches ≥ 15 days per month for ≥ 3 months) are a major cause of pain and disability and effect 2-4% of the population. Self-management programmes have been used in a range of chronic diseases however there is limited evidence available currently for use in the treatment of chronic headaches. Our aim is to test the effectiveness and cost effectiveness of a group education and self-management intervention compared with a best usual care and a relaxation CD for people living with chronic headaches.

Approach

This is a multi-centre randomised controlled trial. All participants have a telephone headache classification interview with a nurse. Participants randomised to the CHESS intervention attend a two day group intervention facilitated by a nurse and allied health professional followed by a one-to-one consultation with a nurse and up to eight weeks of telephone support. Those in the control intervention receive a relaxation CD. The primary outcome is the Headache Impact Test (HIT-6) and secondary outcomes include: headache frequency, generic health related quality of life, emotional well-being and self-efficacy; with follow-up data collected at 4, 8 and 12 months after randomisation. Our primarily source of recruitment is from general practice, supplemented by self-referral from posters in general practices and pharmacies. We seek to recruit around 689 participants 18 years or older with chronic headache from the Midlands and Greater London.

Findings

To date 34 practices have agreed to take part in the study and we have written to 2785 patients in 20 practices in the West Midlands and received an average 27% response. Of those interested in taking part in the study about half have been eligible and so far 90 participants have provided written consent. We have successfully run five intervention groups. Over the next few months we start recruitment in London, Staffordshire and Thames Valley and anticipate recruiting 350 participants by September 2018.

Consequences

We have demonstrated the feasibility of recruiting to a study of a group based intervention to support people with chronic headaches and will present the challenges and facilitators to recruitment and a study update.