title: Patients' management of migraine and chronic daily headache: a study of the members of the Migraine Action Association (United Kingdom).
abstract: BACKGROUND
  Many strategies are available to treat and prevent migraine and chronic daily headache (CDH). Broadly these strategies can be divided into four groups, including (i) health care consultations, (ii) medication and alternative remedies, (iii) general (acute and prophylactic) strategies, and (iv) social support.
  
  
  OBJECTIVE
  This study aimed to compare headache management between migraine (MO), migraine with aura (MA), and those with CDH over the last 12 months.
  
  
  METHODS
  A postal questionnaire was sent to 887 members of the Migraine Action Association (MAA). The response rate was 60.5% (n=537), and 438 questionnaires were included in the analysis. Migraine (n=117) and MA (n=239) patients were classed according to the International Headache Society (IHS). CDH (n=82) was diagnosed when respondents had 15 or more headache days per month. Descriptive tests, analysis of variances (ANOVAs), chi2, and Kruskal-Wallis tests were used for statistical analysis (P<.05).
  
  
  RESULTS
  The three groups did not differ in age, gender, ethnicity, level of education, and employment status. Significant differences in management strategies between the groups were found in the number of respondents who had consulted headache specialists (P=.002) and neurologists (P=.004), the number and types of acute medications (eg, triptans, P=.002), the use of antidepressants (P=.004), and some acute and prophylactic avoidance techniques. Although, no significant differences between the groups were found in the use of other health professionals (eg, GP), alternative health professionals, general acute management, and the use of social support, they all actively used these strategies.
  
  
  CONCLUSIONS
  The respondents of this study were active users of management strategies that are based on a combination of health care consultations, medication and alternative remedies, general management, and social support. In comparison to previous findings, the respondents in this study frequently reported higher use of management strategies (such as the use of triptans), which may be related to this group of patients being better informed about headache management than those with headache within the general population. Thus, the findings may not be representative for the general population, but they give an indication of the influence and importance of headache-related education carried out by patient organizations such as the MAA.
authors.affiliation: University of Surrey, European Institute of Health and Medical Sciences, Guildford, Surrey, United Kingdom
authors.forename: Michele
authors.initials: M
authors.lastname: Peters
authors.forename: Huda Huijer
authors.initials: HH
authors.lastname: Abu-Saad
authors.forename: Ian
authors.initials: I
authors.lastname: Robbins
authors.forename: Vasso
authors.initials: V
authors.lastname: Vydelingum
authors.forename: Andrew
authors.initials: A
authors.lastname: Dowson
authors.forename: Margaret
authors.initials: M
authors.lastname: Murphy
mesh_terms: D005260:Female; D020773:Headache Disorders / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000517:prevention & control / Q000628:therapy*; D012017:Referral and Consultation; D012648:Self Care; D012944:Social Support; D011795:Surveys and Questionnaires; D006113:United Kingdom