Abstract
Background/Objectives There are no robust Australian population-based data on migraine, tension-type headache (TTH) or medication-overuse headache (MOH). In this pilot cross-sectional study, we assessed the participation rate, preferred response method, and acceptability of self-report questionnaires to inform the conduct of a future nationwide epidemiological study.
Methods We created a self-report questionnaire including modules from the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, adding EQ5D (quality of life), and treatment gap questions. We mailed invitations to 20,000 randomly selected households across Australia’s two most populous states. Respondents could return hard-copy questionnaires or enter responses online.
Results Participation rate was 5.0% (N=1,000). Among responders, median age was 60 years (IQR 44–71 years), and 64.7% (n=647) were female. Hard copy (n=736) was the preferred response method. Age-gender-state standardised rates of active headache disorders (symptoms within the last 12 months) were 36.0% for migraine, 32.0% for TTH, 3.6% for probable MOH, and 6.5% for unclassified headache. An additional 12.0% of respondents experienced headaches 15+ days/month. The further enquiries revealed significantly reduced quality of life compared to Australian population norms, and gave a strong impression of substantial treatment gaps.
Conclusion This pilot study demonstrates the need for different methodology to achieve satisfactory engagement in a future nationwide headache epidemiological study, for example through inclusion of headache-related questions in well-resourced, interview-based national health surveys that are conducted regularly by government agencies. Additional future research directions include defining and addressing treatment gaps to improve awareness of headache disorders and minimise under-diagnosis and under-treatment.
