Why HURT? A review of clinical instruments for headache management

Dawn C. Buse, C. Mark Sollars, Timothy J. Steiner, Rigmor H. Jensen, Mohammed A. Al Jumah, Richard B. Lipton

Research output: Contribution to journalReview articlepeer-review

47 Scopus citations


The Global Campaign against Headache, directed by the non-governmental organization Lifting The Burden (LTB) in official relations with the World Health Organization (WHO), aspires to reduce the global burden of headache. Ultimately this calls for improvements in headache management, largely in primary care, where most people with headache receive medical care. In support, LTB is developing a range of headache management aids for primary care. Presently, no single instrument covers the range of assessment and decision-making necessary for successful headache management, and few make the important link between assessment and clinical advice. Expressly to fill this gap, LTB has developed a new instrument: the Headache Under-Response to Treatment (HURT) Questionnaire, an eight-item, self-administered questionnaire addressing headache frequency, disability, medication use and effect, perceptions of headache "control" and knowledge of diagnosis. This instrument is intended not only to evaluate current headache outcomes and assess the need for and response to treatment, but also to provide guidance on appropriate actions towards treatment optimization. The first draft of the HURT was created by an expert consensus group, meeting atWHO headquarters in Geneva, Switzerland. The final version came about through multiple refinements following psychometric testing. Assessment of clinical utility is ongoing in multiple countries.

Original languageEnglish (US)
Pages (from-to)237-254
Number of pages18
JournalCurrent pain and headache reports
Issue number3
StatePublished - Jun 2012


  • Acute treatment
  • Assessment
  • Diagnosis
  • Global Campaign Against Headache
  • Headache
  • Headache impact
  • Headache-related disability
  • Health-related quality of life
  • Migraine
  • Preventive treatment
  • Psychiatric comorbidities
  • Treatment optimization
  • Treatment planning
  • Treatment satisfaction

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


Dive into the research topics of 'Why HURT? A review of clinical instruments for headache management'. Together they form a unique fingerprint.

Cite this