Evidence map›Paper›PMID 38745132›Full record

Trial reportThe journal of headache and pain2024

Does pain self-efficacy predict, moderate or mediate outcomes in people with chronic headache; an exploratory analysis of the CHESS trial.

Siew Wan Hee, Shilpa Patel, Harbinder Sandhu, Manjit S Matharu, Martin Underwood, CHESS Team

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Can pain self-efficacy mediate the influence of pain intensity on outcomes for patients with musculoskeletal pain? A prospective mediation analysis with 12 months follow-up.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  2. 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.

Siew Wan HeeUniversity Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, Coventry, UK. SiewWan.Hee@uhcw.nhs.uk.
Shilpa PatelUniversity Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, Coventry, UK.
Harbinder SandhuWarwick Medical School, University of Warwick, CV4 7AL, Coventry, UK.
Manjit S MatharuQueen Square Institute of Neurology, University College London, Queen Square, WC1N 3BG, London, UK.
Martin UnderwoodUniversity Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, Coventry, UK.
CHESS Team

Funding

National Institute for Health Research (NIHR) Programme Grants for Applied Research RP-PG-1212-20018
6 · The paper itself

Abstract

backgroundChronic headache disorders are disabling. The CHESS trial studied the effects of a short non-pharmacological intervention of education with self-management support for people affected by migraine and/or tension type headache for at least 15 days per month for at least three months. There were no statistically significant effects on the Headache Impact Test-6 (HIT-6) at 12-months. However, we observed improvement in pain self-efficacy questionnaire (PSEQ) and short-term HIT-6. We explored the impact of the CHESS intervention on PSEQ, and subsequently, on the HIT-6 and chronic headache quality of life questionnaire (CH-QLQ) at four, eighth and 12 months.

methodsWe included all 736 participants from the CHESS trial. We used simple linear regression models to explore the change of HIT-6 and CH-QLQ with treatment and PSEQ at baseline (predictor analysis), and the interaction between treatment and baseline PSEQ (moderator analysis). We considered the change of PSEQ from baseline to four months as a mediator in the mediation analysis.

resultsBaseline PSEQ neither predicted nor moderated outcomes. The prediction effect on change of HIT-6 from baseline to 12 months was 0.01 (95% CI, -0.03 to 0.04) and the interaction (moderation) effect was -0.07 (95% CI, -0.15 to 0.002). However, the change of PSEQ from baseline to 4-month mediated the HIT-6 (baseline to 8-, and 12-month) and all components of CH-QLQ (baseline to 8-, and 12-month). The CHESS intervention improved the mediated variable, PSEQ, by 2.34 (95% CI, 0.484 to 4.187) units and this corresponds to an increase of 0.21 (95% CI, 0.03 to 0.45) units in HIT-6 at 12-months. The largest mediated effect was observed on the CH-QLQ Emotional Function, an increase of 1.12 (95% CI, 0.22 to 2.20).

conclusionsPSEQ was not an effective predictor of outcome. However, change of short-term PSEQ mediated all outcomes, albeit minimally. Future behavioural therapy for chronic headache may need to consider how to achieve larger, and more sustained increases level of self-efficacy than that achieved within the CHESS trial.

trial registrationISRCTN79708100.

Indexed as

Self EfficacyAdultFemaleHeadache DisordersHumansMaleMiddle AgedMigraine DisordersPatient Education as TopicQuality of LifeSelf-ManagementSurveys and QuestionnairesTreatment OutcomeBehavioural therapyChronic migraineChronic tension type headacheEducationEpisodic headacheMediatorMedication overuseModeratorPredictorSelf-management

Identifiers

PMID38745132
PMCPMC11094916

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.