Headache in General Practice: Frequency, Management, and Results of Encounter

Abstract

Objective. Headache is a common reason for consulting the general practitioner. The goal of the investigation was to characterize the headache consultation rates, the associated symptoms, the frequency of diagnostic and therapeutic procedures, and the results of the encounter of patients with headache. Methods. Cross-sectional data were collected from randomly selected patients during the German SESAM 2 study and compared with unpublished but publicly available data from the Dutch Transition Project. Results. Headache accounts for up to five percent of all general practice consultations. Women consult the general practitioner for headache twice as often as men. Physical examination and drug prescription are the most frequent procedures. Most of the patients suffer from primary headache; secondary headache is due to upper respiratory tract infections or problems of the spinal column. Dangerous courses occur in very rare cases. Conclusion. This work confirms the findings of earlier studies regarding the management of patients that consult the general practitioner for headache. It broadens the preexisting database since cross-sectional data regarding headache in general practice was rarely published.

Non-clinical factors associated with headache presentations in patients with psychological co-morbidities: a 7-year retrospective study

“…The observation that a large majority (78.9%) of the entire 517 patients seen for headaches (Table 1) did not require imaging appears to be consistent with reports of multiple studies, which all found that drug prescriptions [1], physical examinations and history [1,23] are the common methods of managing headaches in primary care and not head imaging.…”

“…Headaches are a common reason for primary care consultations in general practice [1][2][3] and account for up to 1.5% of all visits per year [1]. The social, economic and personal costs of headaches can be considerable [4,5].…”

“…Dangerous causes of headaches are, however, rare [1,3,5] and most cases in general practice are treated only by physical examination, drug prescriptions [1] and reassurances [6]. However, where deemed relevant, General Practitioners (GPs) do refer patients for investigations such as neuroimaging (covering head and brain scans) or specialist opinions [6].…”

Green Flags and headache: A concept study using the Delphi method

“…Headaches are common complaints of patients presenting to general practitioners, emergency-room doctors, and neurologists. [1][2][3] A common clinical approach is to first assess whether the headache is a primary headache disorder (e.g., migraine, tension-type headache) or secondary to another disorder (e.g., stroke, infection, tumor). 4 Despite promising advances, 5 there are no available biomarkers for primary headache disorders.…”

Qualidade da referenciação dos cuidados de saúde primários para a consulta de cefaleias de um hospital terciário

“…1 Estudos internacionais mostraram que as cefaleias são responsáveis por 1,5 a 5,4% de todas as consultas do médico de família, sendo que cerca de 2-3% desses doentes são referenciados para os cuidados de saúde secundários para avaliação mais especializada. 6 O único estudo realizado em Portugal verificou que a cefaleia correspondeu a 0,7% do total de motivos de consulta e 2,1% do total de sinais/sintomas classificados pelo médico de família na International Classification for Primary Care -versão 2 (ICPC-2). 7 A referenciação representa um veículo de informação singular entre o médico de família e o neurologista.…”