2010 Neurological Institute Outcomes - Cleveland Clinic

Pain / Headache
The Headache Program, within the Neurological Center for Pain, utilizes the Headache Impact Test (HIT-6) as a
standard health status measure for all patients treated in the center. HIT-6 is a disease-specific survey that captures
the effects of headache and its treatment on functional health and well-being.
Chronic Migraine
Chronic migraine refers to migraine headaches occurring at least 15 days per month, frequently associated with significant
functional impairment and depression. Patients with chronic migraine often present for treatment with excessive and
prolonged use of opioids, triptans or other analgesics, which can exacerbate the headache in the long term.
Functional Impairment: New Chronic Migraine Patients with and without Medication Overuse Headache (MOH)
2009 – 2010
Mean HIT-6 Score
76
72
68
64
60
56
N =
Mean PHQ-9 Score
18
15
12
9
6
3
0
Patients without MOH
N =
59
Neurological Institute
Patients without MOH
58
Patients with MOH
42
Depression: New Chronic Migraine Patients with and without MOH
2009 – 2010
Patients with MOH
41
2009 First Visit
2009 Interval Visit
2010 Last Visit
2009 First Visit
2009 Interval Visit
2010 Last Visit
Functional impairment, as measured
with the HIT-6, in chronic migraine
patients seen for the first time at
Cleveland Clinic’s Neurological
Center for Pain in 2009 and
followed into 2010 showed
improvement over time, in patients
with medication overuse headache
(MOH) as well as those without
(P < 0.0001). Those patients
with MOH were more impaired, in
general, than those without.
Depressive symptoms, as measured
with the PHQ-9, improved in
chronic migraine patients initially
seen in 2009 and followed into
2010 in patients with MOH as well
as those without (P < 0.0001).
83