SUMMARY During a survey of a defined community, 2,933 women aged 20 to 64 years were asked standard questions about headaches. Overall, 78-7% had headaches during the year immediately preceding the survey and this proportion decreased significantly with age. Random samples of subgroups with unilateral headaches, headaches preceded by a warning, and headaches accompanied by nausea were examined clinically. From these clinical diagnoses the prevalence of women with migraine during the previous year was estimated as 19 %. Nearly half of those diagnosed as having migraine had never consulted a doctor because of headaches. Women with migraine and nonmigrainous headaches kept diaries of all headaches and data are presented for the time and day of onset, severity, duration and relation of menstruation for both types of headache.

1 Prescription information leaflets (PILs) giving information about non-steroidal antiinflammatory drugs (NSAIDs), ,B-adrenoceptor antagonists and inhaled bronchodilators were evaluated in three small Hampshire towns, while a fourth, in which no leaflets were distributed, acted as a control. 2 Seven hundred and nineteen (82%) patients prescribed one of these medicines agreed to be interviewed in their homes, 1 to 2 weeks after the medicine had been prescribed. Four hundred and nineteen of them had received leaflets, while 300 received no written information. Two hundred and sixty patients received their leaflets from a pharmacist while 159 were given them by their general practitioner. 3 Patients who received leaflets were better informed about every item of knowledge tested, except for the name of the medicine. Awareness of the side effects showed the greatest improvement, but there was no evidence that these leaflets produced spurious side effects. 4 Much improved levels of satisfaction were recorded amongst patients who received leaflets, especially those for NSAIDs (P < 0.001) and for ,B-adrenoceptor antagonists (P < 0.01). 5 Subsequently, three hundred and fifty-eight (77%) of the patients prescribed either a NSAID or a ,3-adrenoceptor antagonist 1 year earlier responded to a postal questionnaire. The benefits in terms of knowledge and satisfaction were still apparent, although less marked than previously. Of the patients still taking P-adrenoceptor antagonists 70% had retained their leaflets over the intervening 12 months. 6 Ninety-seven per cent of patients read their leaflet regardless of whether it was distributed by a general practitioner or pharmacist. However, those who obtained it from a pharmacist tended to be more knowledgeable and satisfied. 7 We conclude that patients welcome the idea of receiving PILs. They improve patients' knowledge of how to take their medicines correctly and their awareness of potential side effects. Importantly, patients who receive leaflets are more satisfied than those who do not. These overall benefits justify the use of leaflets on a routine basis.

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SYNOPSISThe prevalence of migraine in the general population has been calculated using a standard mailed questionnaire, which inquired about headache and the individual features of migraine, and which previously had been compared with a clinical diagnosis. In three separate epidemiological surveys the prevalence in the preceding year was found to be between 23 and 2900 in women and between 15 and 20% in men. The prevalence declined with age in both men and women.These surveys show that migraine is much more prevalent than the frequently quoted figure of about 10% of the population which does not seem to be based on any particular survey.The finding that nearly half of all the women who had been clinically diagnosed as having migraine in a community survey had never consulted any doctor about their headaches (Waters and O'Connor, 1971) casts doubts on many previous estimates of the prevalence of migraine. The frequently quoted figure of about l0%O seems to be little more than a consensus of opinion and often does not specify whether this is for men, women, or both, or the age ranges involved. Studies in Great Britain had previously been done in general practice (Logan and Cushion, 1958;Walker, 1959;Fry, 1966; Office of Population Censuses and Surveys, 1974), as part of larger surveys (Brewis et al., 1966), and in occupational groups (Childs and Sweetnam, 1961). The data on the prevalence of migraine in these studies gave widely conflicting results which may have been due to patients with migraine not attending their general practitioners, to the lack of a suitable definition of the condition, or to a poor response rate in the survey.A number of community surveys of the prevalence of headache and of the prevalence of the features of migraine have recently been published (Waters, 1974a, b). In this paper, the data from three of these surveys are brought together and are used for the first time to calculate the prevalence of migraine in men and women in

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Leaflets containing information about medicines were issued to 56 patients prescribed penicillins and 43 patients prescribed non-steroidal anti-inflammatory drugs. The patients were interviewed between four and 10 days later and their responses compared with those of 65 patients prescribed penicillin and 33 prescribed nonsteroidal anti-inflammatory drugs who did not receive a leaflet. Patients who received a leaflet were more likely to be completely satisfied with their treatment and with the information they had been given. They were also more likely to know the name of their medicine and much more aware of potential unwanted effects. Although there was no evidence that knowledge increased the incidence of adverse effects, when these did occur they were more likely to be recognised as being due to the medicine. Further studies of other leaflets are warranted, including leaflets for drugs that are taken long term.

Two postal questionnaire surveys were carried out among the adult population of Southampton aimed at clarifying the diagnostic criteria for asthma (study 1) and at testing the validity of symptoms so identified as diagnostic of bronchial hyperreactivity (study 2). The questionnaires asked about respiratory symptoms and included three questions thought likely to disclose increased bronchial reactivity. Laboratory measurements on subsamples of respondents included spirometry and bronchial challenge with increasing doses of histamine till a concentration was reached provoking a fall of more than 20% (PC>20) in forced expiratory volume in one second.In the first study no normal subject (that is, one who did not report shortness of breath or wheezing on the questionnaire) had a PC>20 below 0-5 g/l. Of 51 subjects who reported shortness of breath or wheezing, or both, nine had a cluster of abnormalities consisting of one or more symptoms of bronchial irritability, nocturnal dyspnoea, and prolonged morning tightness together with PC>20 values of 0-5 g/l or less. These symptoms in conjunction with a low PC>20 were termed the bronchial irritability syndrome. In the second study bronchial challenge confirmed the close association of these symptoms with bronchial hyper-reactivity, all other subjects being less reactive to histamine. Only 27% of subjects with symptoms of the bronchial irritability syndrome had been diagnosed as asthmatic by their general practitioners.The bronchial irritability syndrome is a definable entity for epidemiological study and patient care.