Evidence map›Paper›PMID 36609224›Full record

Trial reportBMC neurology2023

Chronic Headache Education and Self-Management Study (CHESS): a process evaluation.

David R Ellard, Vivien P Nichols, Frances E Griffiths, Martin Underwood, Stephanie J C Taylor, CHESS team (Consortium)

Open access · goldAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Psychological interventions for migraine.Nature reviews. Neurology · 2026
    Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

David R EllardWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK. d.r.ellard@warwick.ac.uk.
Vivien P NicholsWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Frances E GriffithsDivision of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Martin UnderwoodWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Stephanie J C TaylorWolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AB, UK.
CHESS team (Consortium)
University of Warwick · GBQueen Mary University of London · GBUniversity Hospitals Coventry and Warwickshire NHS Trust · GB

Funding

Programme Grants for Applied Research RP-PG-1212-20018
6 · The paper itself

Abstract

backgroundThe Chronic Headache Education and Self-Management Study (CHESS) multicentre randomised trial evaluated the impact a group education and self-management support intervention with a best usual care plus relaxation control for people living with chronic headache disorders (tension type headaches or chronic migraine, with or without medication overuse headache). Here we report the process evaluation exploring potential explanations for the lack of positive effects from the CHESS intervention.

methodsThe CHESS trial included 736 (380 intervention: 356 control) people across the Midlands and London UK. We used a mixed methods approach. Our extensive process evaluation looked at context, reach, recruitment, dose delivered, dose received, fidelity and experiences of participating in the trial, and included participants and trial staff. We also looked for evidence in our qualitative data to investigate whether the original causal assumptions underpinning the intervention were realised.

resultsThe CHESS trial reached out to a large diverse population and recruited a representative sample. Few people with chronic tension type headaches without migraine were identified and recruited. The expected 'dose'of the intervention was delivered to participants and intervention fidelity was high. Attendance ("dose received") fell below expectation, although 261/380 (69%) received at least at least the pre-identified minimum dose. Intervention participants generally enjoyed being in the groups but there was little evidence to support the causal assumptions underpinning the intervention were realised.

conclusionsFrom a process evaluation perspective despite our extensive data collection and analysis, we do not have a clear understanding of why the trial outcome was negative as the intervention was delivered as planned. However, the lack of evidence that the intervention causal assumptions brought about the planned behaviour change may provide some insight. Our data suggests only modest changes in managing headache behaviours and some disparity in how participants engaged with components of the intervention within the timeframe of the study. Moving forwards, we need a better understanding of how those who live with chronic headache can be helped to manage this disabling condition more effectively over time.

trial registrationISRCTN79708100 .

Indexed as

Headache DisordersMigraine DisordersSelf-ManagementTension-Type HeadacheHeadacheHumansBehaviour change interventionChronic headacheFidelityMixed methodsProcess evaluation

Identifiers

PMID36609224
PMCPMC9823254
OpenAlexW4313639182

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.