Characteristics of Patients Referred To A Specialized Headache Clinic

• Published in: Scientific reports 2020-01, Vol.10 (1), p.1146-1146, Article 1146
• Main Authors: Fejes, Eva, Feher, Gergely, Gurdan, Zsuzsanna, Gombos, Katalin, Koltai, Katalin, Pusch, Gabriella, Tibold, Antal
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/617/375/226/1654; Adult; Age; Aged; Analgesics, Opioid - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Benzodiazepines; Benzodiazepines - therapeutic use; Brain Neoplasms - complications; Brain Neoplasms - secondary; Comorbidity; Computed tomography; Female; General Practitioners; Headache; Headache Disorders - diagnostic imaging; Headache Disorders - drug therapy; Headache Disorders - epidemiology; Headache Disorders - etiology; Headaches; Humanities and Social Sciences; Humans; Hungary - epidemiology; Magnetic Resonance Imaging; Male; Medical imaging; Medical Overuse; Meningitis; Meningitis - complications; Middle Aged; Migraine; multidisciplinary; Neuroimaging; Neuroimaging - statistics & numerical data; Neurologists; Opioids; Outpatient Clinics, Hospital - statistics & numerical data; Patients; Practice Patterns, Physicians' - statistics & numerical data; Primary care; Referral and Consultation; Retrospective Studies; Science; Science (multidisciplinary); Stroke - complications; Tomography, X-Ray Computed; Tryptamines - therapeutic use
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-58234-w

Headache is a common problem with great effect both on the individual and on the society. Recent studies raised the possibility of increasing rate of specialty referrals, inappropiate treatment and advanced imaging for simple headache. The aim of our study was to analyze the characteritics of patients (including duration of symptoms, headache type, brain imaging, treatment) referred to our specialized headache clinic between 01/01/2014 and 01/01/2015 by their general practitioners and primary care neurologists due to chronic/treatment-resistant headache syndromes. 202 patients (mean age 53.6 ± 17.6 years) were evaluated in our clinic (102 females, mean age 50.14 ± 16.11 years and 100 males, mean age 57 ± 18.1 years). Migraine (84/202) and tension-type (76/202) were the most common syndromes. 202 plain brain CT, 60 contrast-enhanced CT and 128 MRI were carried out by their general practitioners or other healthcare professioners including neurologists before referral to our headache centre. Despite of extensive brain imaging appropiate treatment was started less than 1/3 of all patients and significant proportion received benzodiazepines or opioid therapy. Furthermore, more than 10% of referred patients presented with secondary headache including one meningitis. The management of headache is still a challenge for primary care physicians leading to medical overuse. Vast majority of our patients should not be referred to our specialized headache clinic as they had uncomplicated headache or other underlying conditions than pain.