Headache diagnosis in primary care

Ridsdale, Leone, Dowson, Andrew, Clark, Lucy V. ORCID: https://orcid.org/0000-0001-7162-0512, Goldstein, Laura H., Marsh, Barry, Morgan, Myfanwy, McCrone, Paul and Seed, Paul T. (2014) Headache diagnosis in primary care. Journal of Neurology and Neurosurgery, 1 (2). ISSN 2373-8995

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Introduction: Doctors in primary care are responsible for diagnosing and managing patients with headache, but frequently lack confidence in doing so. We aimed to compare Family Practitioners’ (FPs) diagnosis of headaches to classification based on a symptom questionnaire, and to describe how classification links to other important clinical features. Methods: This was an observational study of patients attending primary care doctors for headache. Main outcome measures: Patients completed a questionnaire including the Headache Impact Test, the Migraine Disability Assessment Score, the Hospital Anxiety and Depression Scale, the Illness Perceptions Questionnaire, a satisfaction scale, a service use inventory and a symptom questionnaire rated by two Practitioners with Special Interest (PSIs) in Headache. Results: 255 patients completed questionnaires. There was low agreement between FP diagnosis and classification using the symptom questionnaire. FPs frequently did not use the diagnosis migraine, when patient reported symptoms which justified this. FPs did not classify patients with ≥15 days of headache separately as chronic daily headache (CDH), and this could be because the classification system used does not have that code. Patients classified as CDH using the symptom questionnaire reported more disability, more symptoms of anxiety and depression (HADS), more service use, and less satisfaction with FP care. Conclusion: Patients, who present with headache in primary care, tend to receive non-specific diagnoses. Having a system that would allow separate classification of people with headache of ≥ 15 days a month might help FPs to explore and address associated features with patients in terms of disability, psychological co-morbidity and cost, and improve satisfaction with care.

Item Type: Article
Uncontrolled Keywords: diagnosis,primary care,headache,migraine,chronic daily headache
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Centres > Population Health
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Depositing User: Pure Connector
Date Deposited: 04 Aug 2017 05:06
Last Modified: 06 Jun 2024 14:59
URI: https://ueaeprints.uea.ac.uk/id/eprint/64342
DOI: 10.19104/jnn.2014.79


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