Table 3.
Delphi round 2. Results of domain prioritisation for chronic migraine (combined panels n=31)†
| Rank* | Domain and definition | Top 10/31 prioritised domains | Top 50% of prioritised domains (rank 1–15/31 inclusive) | Lower 50% of prioritised domains (rank 16–31 inclusive) |
| 1 | Pain
|
Severity or intensity of pain associated with a migraine (1/31) | ||
| Pain associated with a migraine—experience of an unpleasant sensation that aches or hurts (2/31) | ||||
| Frequency of pain associated with a migraine (3/31) | ||||
| Duration of pain associated with a migraine (4/31) | ||||
| 2 | Usual activities
|
Being able to carry out usual tasks or daily activities inside or outside the home (not related to paid employment) that support an independent lifestyle—such as tidying one’s home, walking short distances, managing finance, driving, usual technology (instrumental activities of daily life) (5/31) | ||
| Being able to carry out activities related to work (paid or unpaid) or study to an acceptable or usual standard (6/31) | ||||
| Needing to take time off work (paid or unpaid) or study (11/31) | ||||
| Family roles—able to provide usual care or support for family or close friends, including ability to commit activities (19/31) | ||||
| Participation in social or leisure activities—ability to participate in, or commit to, social or leisure activities (22/31) | ||||
| 3 | Cognition
|
Cognitive function—difficulty concentrating, ability to think ‘clearly’ or to remember things (7/27) | ||
| 4 | Adverse events | Treatment side effects—experiencing undesired secondary effects from taking medications for migraine (8/31) | ||
| Mortality (death) (26/31)† prioritised in top 50% (15/31) by HCPs | ||||
| 5 | Associated symptoms | Increased sensitivities—to light, sound, smell or touch (9/31) | ||
| Physical fatigue—experiencing physical fatigue, tiredness, lacking in energy and feeling physically exhausted (10/31) | ||||
| Sleep quality—being able to have a restful sleep (14/31) | ||||
| Needing to rest or lie down because of a headache (15/31) | ||||
| 6 | Medication use | Satisfaction with treatment (12/31) | ||
| The type (potency) and dose (how much) of a medication taken to prevent a migraine (21/31) | ||||
| Consistency in treatment effect (23/31) | ||||
| The type (potency) and dose (how much) of a medication taken during a migraine (24/31) | ||||
| Confidence in treatment (28/31) | ||||
| 7 | Overall health | An individual’s general health status; the ability to ‘live a normal life’ (13/31) | ||
| 8 | Emotional well-being | Stress—feelings of distress, frustration or irritation (16/31)† prioritised in top 10 (10/31) by HCPs | ||
| Anxiety—concerned, worried, fearful or anxious (20/31) | ||||
| Self-worth—feeling like a burden to others; can include feeling valued or helpless; accepted or rejected; and feelings of self-esteem (28/31) | ||||
| Feelings of isolation—feeling isolated and reduced social interactions (29/31) | ||||
| Social role—relationship with work colleagues or peers (31/31) | ||||
| 9 | Self-management | Self-management—ability to effectively decrease/minimise/control the impact of a migraine on oneself (eg, pharmaceutical, diet, lifestyle choices, etc) (17/31) | ||
| Unpredictability of a migraine—uncertainty of being symptom free or able to engage in activities (18/31)† prioritised in top 50% (14/31) by patients | ||||
| 10 | Financial impact | Economic cost associated with treatment for a headache (to the individual (out-of-pocket expenses) and healthcare system) (25/31) | ||
| Use of healthcare resources in response to headache (30/31) |
*Top 5 grouped domains—informed by top 10 prioritised domains. Top 7 grouped domains—informed by top 13 and top 50% of prioritised domains (15/31).
†3 domains prioritised differently between the 2 panels; considered further in round 3.
HCPs, healthcare professionals.