Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation
Abstract Background & objectives Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to substantial morbidity and disability, little data exists about patients’ perspectives. Without h...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-08-01
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| Series: | Journal of Patient-Reported Outcomes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41687-023-00625-4 |
| _version_ | 1797452470461399040 |
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| author | Timothy J. Amrhein Molly McFatrich Kate Ehle Michael D. Malinzak Linda Gray Peter G. Kranz E. Hope Weant Christina K. Zigler |
| author_facet | Timothy J. Amrhein Molly McFatrich Kate Ehle Michael D. Malinzak Linda Gray Peter G. Kranz E. Hope Weant Christina K. Zigler |
| author_sort | Timothy J. Amrhein |
| collection | DOAJ |
| description | Abstract Background & objectives Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to substantial morbidity and disability, little data exists about patients’ perspectives. Without hearing directly from patients, our understanding of the full experience of having SIH is limited, as is our ability to identify and use appropriate patient-reported outcome measures (PROMs) within clinical care and research. The purpose of this study was to conduct qualitative interviews with confirmed SIH patients to fully describe their experiences and identify relevant concepts to measure. Methods Patients were recruited from an SIH specialty clinic at a large, U.S.-based healthcare center. Patients undergoing an initial consultation who were ≥ 18 years old, English-speaking, met the International Classification of Headache Disorders-3 criteria for SIH, and had a brain MRI with contrast that was positive for SIH were eligible to participate. During semi-structured qualitative interviews with a trained facilitator, participants were asked to describe their current SIH symptoms, how their experiences with SIH had changed over time, and the aspects of SIH that they found most bothersome. Analysts reviewed the data, created text summaries, and wrote analytic reports. Results Fifteen participants completed interviews. Common symptoms reported by patients included headache, tinnitus, ear fullness/pressure/pain, and neck or interscapular pain. Patients reported that their symptoms worsened over the course of their day and with activity. The most bothersome aspect of SIH was disruption to daily activities and limits to physical activities/exercise, which were severe. With regard to symptoms, the most bothersome and impactful included physical pain and discomfort (including headache), as well as fatigue. Conclusions Patients reported a diverse set of symptoms that were attributed to SIH, with devastating impacts on functioning and high levels of disability. Researchers considering use of PROMs for SIH should consider inclusion of both symptom scales and aspects of functioning, and future work should focus on evaluating the validity of existing measures for this patient population using rigorous qualitative and quantitative methods in diverse samples. Additionally, these data can be used to assist clinicians in understanding the impacts of SIH on patients. |
| first_indexed | 2024-03-09T15:09:09Z |
| format | Article |
| id | doaj.art-becc404d0f2240629c5bd1cd3220f467 |
| institution | Directory Open Access Journal |
| issn | 2509-8020 |
| language | English |
| last_indexed | 2024-03-09T15:09:09Z |
| publishDate | 2023-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj.art-becc404d0f2240629c5bd1cd3220f4672023-11-26T13:29:41ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202023-08-01711910.1186/s41687-023-00625-4Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitationTimothy J. Amrhein0Molly McFatrich1Kate Ehle2Michael D. Malinzak3Linda Gray4Peter G. Kranz5E. Hope Weant6Christina K. Zigler7Department of Radiology, Duke University Medical CenterDepartment of Population Health Sciences, Duke University School of MedicineDepartment of Population Health Sciences, Duke University School of MedicineDepartment of Radiology, Duke University Medical CenterDepartment of Radiology, Duke University Medical CenterDepartment of Radiology, Duke University Medical CenterDepartment of Radiology, Duke University Medical CenterDepartment of Population Health Sciences, Duke University School of MedicineAbstract Background & objectives Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to substantial morbidity and disability, little data exists about patients’ perspectives. Without hearing directly from patients, our understanding of the full experience of having SIH is limited, as is our ability to identify and use appropriate patient-reported outcome measures (PROMs) within clinical care and research. The purpose of this study was to conduct qualitative interviews with confirmed SIH patients to fully describe their experiences and identify relevant concepts to measure. Methods Patients were recruited from an SIH specialty clinic at a large, U.S.-based healthcare center. Patients undergoing an initial consultation who were ≥ 18 years old, English-speaking, met the International Classification of Headache Disorders-3 criteria for SIH, and had a brain MRI with contrast that was positive for SIH were eligible to participate. During semi-structured qualitative interviews with a trained facilitator, participants were asked to describe their current SIH symptoms, how their experiences with SIH had changed over time, and the aspects of SIH that they found most bothersome. Analysts reviewed the data, created text summaries, and wrote analytic reports. Results Fifteen participants completed interviews. Common symptoms reported by patients included headache, tinnitus, ear fullness/pressure/pain, and neck or interscapular pain. Patients reported that their symptoms worsened over the course of their day and with activity. The most bothersome aspect of SIH was disruption to daily activities and limits to physical activities/exercise, which were severe. With regard to symptoms, the most bothersome and impactful included physical pain and discomfort (including headache), as well as fatigue. Conclusions Patients reported a diverse set of symptoms that were attributed to SIH, with devastating impacts on functioning and high levels of disability. Researchers considering use of PROMs for SIH should consider inclusion of both symptom scales and aspects of functioning, and future work should focus on evaluating the validity of existing measures for this patient population using rigorous qualitative and quantitative methods in diverse samples. Additionally, these data can be used to assist clinicians in understanding the impacts of SIH on patients.https://doi.org/10.1186/s41687-023-00625-4Spontaneous intracranial hypotensionCSF leakHeadacheConcept elicitationQualitative interview |
| spellingShingle | Timothy J. Amrhein Molly McFatrich Kate Ehle Michael D. Malinzak Linda Gray Peter G. Kranz E. Hope Weant Christina K. Zigler Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation Journal of Patient-Reported Outcomes Spontaneous intracranial hypotension CSF leak Headache Concept elicitation Qualitative interview |
| title | Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation |
| title_full | Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation |
| title_fullStr | Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation |
| title_full_unstemmed | Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation |
| title_short | Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation |
| title_sort | patient experience of spontaneous intracranial hypotension sih qualitative interviews for concept elicitation |
| topic | Spontaneous intracranial hypotension CSF leak Headache Concept elicitation Qualitative interview |
| url | https://doi.org/10.1186/s41687-023-00625-4 |
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