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Published on: June 2, 2014
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Diagnostics and management of headache in general practice
Louise Ninett Carlsen1,2, Simon Stefansen2, Peder Ahnfeldt-Mollerup3,4
1Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark.
Family Practice
|October 29, 2022
Summary
General practitioners (GPs) manage long-lasting headache patients, with a focus needed to reduce opioid use and increase preventive treatments. This ensures more headache patients remain in primary care for better outcomes.
Area of Science:
- Neurology
- General Practice
- Public Health
Background:
- Headache disorders are a significant global health issue, impacting quality of life and increasing disability.
- Despite prevalence, many headache cases can be effectively managed by general practitioners (GPs).
- Insufficient treatment of headache disorders leads to substantial socioeconomic costs.
Purpose of the Study:
- To investigate the management strategies employed by general practitioners for patients experiencing headaches for six months or longer.
- To analyze diagnostic, treatment, and referral patterns in primary care for chronic headache management.
- To identify factors associated with referrals to specialized neurological care.
Main Methods:
- A retrospective, descriptive, cross-sectional study utilizing medical audit data.
- Nineteen general practices in Vejle municipality, Denmark, participated, reviewing 367 patients with long-lasting headaches.
- Data collected included headache diagnoses, treatments administered (simple analgesics, triptans, opioids, preventive medications), and referral outcomes (neurologist, imaging).
Main Results:
- Migraine (44%) and tension-type headache (38%) were the most common diagnoses among the 367 patients.
- A significant proportion of patients used simple analgesics (66%) and triptans (40%), while preventive medication was prescribed to 25%.
- Referral to a neurologist occurred in 48% of cases, and 25% underwent CT or MRI scans; factors influencing referral included multiple diagnoses, post-traumatic headache, unspecific headache, and use of preventive treatment.
Conclusions:
- General practitioners' management of long-lasting headaches requires optimization, particularly concerning medication choices.
- There is a need to reduce the reliance on opioid analgesics and increase the prescription of preventive treatments for chronic headaches.
- Strategies should aim to manage more headache patients effectively within primary care settings, reducing unnecessary referrals.
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