Neurology residents’ knowledge of the management of headache

Kristoffersen, Espen Saxhaug; Faiz, Kashif Waqar; Winsvold, Bendik S.

doi:10.1177/0333102419847973

Cited by 15 publications

(26 citation statements)

References 33 publications

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“…Knowledge about MOH is often scant among clinicians. Recently, Kristoffersen and colleagues reported a lower than expected knowledge and false assumptions on MOH and its treatment from Norwegian neurology residents 144 . Hedenrud and colleagues reported on a lack of knowledge on MOH among pharmacy staff in Sweden.…”

Section: Managing the Headache Patient With Medication Overusementioning

confidence: 99%

The Many Faces of Medication‐Overuse Headache in Clinical Practice

2020

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The management of medication-overuse headache (MOH) is multifaceted and headache experts have different views on the optimal strategy to tackle this type of secondary headache. The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient.Managing MOH in clinical practice starts by evaluating the headache patient with medication overuse, determining the overused drug(s), assessing the impact of headaches on the patient and assessing comorbid conditions and disorders. Withdrawal of the overused medication is the cornerstone of treatment. An inpatient or outpatient setting is chosen based on the clinical profile of the patient. There is evidence for abrupt withdrawal combined with headache preventive treatment.Bridging therapy to bring relief to withdrawal headaches and/or symptoms should be offered. Education and motivational work through multidisciplinary assessment show benefits in sustaining withdrawal and preventing relapse.Although the reversal of chronic headache after cessation of overused acute medication has been noticed worldwide, different aspects of the management of MOH, such as complete or gradual withdrawal, or preventive treatment with or without withdrawal are still debated.

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Section: Managing the Headache Patient With Medication Overusementioning

confidence: 99%

The Many Faces of Medication‐Overuse Headache in Clinical Practice

2020

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“…Yet these ndings are not surprising and in line with ndings from studies conducted in other regions. [11][12][13] As there are no biomarkers or diagnostic tests for most headache disorders, diagnosis rely on the medical history. While headache diaries in general are used for diagnosis and outcome assessment, there is an apparent inconsistent use of the ICHD (Table 3).…”

Section: Discussion Diagnostic Criteriamentioning

confidence: 99%

Barriers and Gaps in Headache Education: A National Cross-sectional Survey of Neurology Residents in Denmark

Phu

Dømgaard

Stefansen

et al. 2021

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Background: A major barrier to adequate headache care is lacking formal education and training of healthcare professionals. Concerted efforts should be made to pinpoint major gaps in knowledge in healthcare professionals to facilitate better educational policies in headache training. The aim of this study was to identify deficiencies and barriers in headache training among residents in neurology in Denmark.Methods: We conducted a national cross-sectional survey of residents in neurology in Denmark from April 2019 to September 2019. The survey included questions on participant demographics, knowledge of and barriers in headache disorders, guidelines and diagnostic tools usage, contact with primary and tertiary care, medication overuse, and non-pharmacological interventions.Results: Sixty residents across Denmark accepted the invitation and 54/60 (90%) completed the survey. Although two-thirds, 35/54 (65%), of the population had prior formalized training in headache disorders, we identified gaps in all explored domains including diagnosis, management, and referral patterns. Particularly, there was an inconsistent use of guidelines and diagnostic criteria from the Danish Headache Society (2.74 (±1.14)), the Danish Neurological Society (3.15 (±0.86)), and the International Classification of Headache Disorders (2.33 (±1.08)); 1: never/have not heard of, 4: always. Headache was ranked second to last out of six sub-specializations in popularity.Conclusions: Overall knowledge on headache disorders amongst neurology residents in Denmark do not meet the expectations set out by national and international recommendations. Stakeholders should make strategic initiatives for structured education in headache for improved clinical outcomes in parallel with costs reduction through resource optimization.

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“…We developed a questionnaire (supplement 1) based on available literature and the authors’ experience in health service research, general practice and headache management [ 3 , 17 ]. The questionnaire covered background variables and the participants responded to a short multiple-choice and open questions about knowledge of and experience in the management of headache, use of the national treatment recommendations and the International Classification of Headache Disorders 3rd edition (ICHD-3) and barriers to optimised treatment.…”

Section: Methodsmentioning

confidence: 99%

“…The focus on headache in the curriculum at medical schools and in specialist training throughout the world is limited [ 1 – 3 ]. Insufficient education, training and knowledge about headache may be a cause of diagnostic failure, inappropriate treatment, and low patient satisfaction among headache patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The management and clinical knowledge of headache disorders among general practitioners in Norway: a questionnaire survey

et al. 2021

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Background General practitioners (GPs) diagnose and manage a majority of headache patients seeking health care. With the aim to understand the potential for clinical improvement and educational needs, we performed a study to investigate Norwegian GPs knowledge about headache and its clinical management. Methods We invited GPs from a random sample of 130 Norwegian continuous medical education (CME) groups to respond to an anonymous questionnaire survey. Results 367 GPs responded to the survey (73% of invited CME groups, 7.6% of all GPs in Norway). Mean age was 46 (SD 11) years, with an average of 18 (SD 10) years of clinical experience. In general the national treatment recommendations were followed, while the International Classification of Headache Disorders and other international guidelines were rarely used. Overall, 80% (n = 292) of the GPs suggested adequate prophylactic medication for frequent episodic migraine, while 28% (n = 101) suggested adequate prophylactic medication for chronic tension-type headache (CTTH). Half (52%, n = 191)) of the respondents were aware that different types of acute headache medication can lead to medication-overuse headache (MOH), and 59% (n = 217) knew that prophylactic headache medication does not lead to MOH. GPs often used MRI in the diagnostic work-up. GPs reported that lack of good treatment options was a main barrier to more optimized treatment of headache patients. Conclusion The knowledge of management of CTTH and MOH was moderate compared to migraine among Norwegian GPs.

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Neurology residents’ knowledge of the management of headache

Cited by 15 publications

References 33 publications

The Many Faces of Medication‐Overuse Headache in Clinical Practice

The Many Faces of Medication‐Overuse Headache in Clinical Practice

Barriers and Gaps in Headache Education: A National Cross-sectional Survey of Neurology Residents in Denmark

The management and clinical knowledge of headache disorders among general practitioners in Norway: a questionnaire survey

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