Management of primary chronic headache in the general population: the Akershus study of chronic headache |
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Authors: | Espen Saxhaug Kristoffersen Ragnhild Berling Grande Kjersti Aaseth Christofer Lundqvist Michael Bj?rn Russell |
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Institution: | 1.Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog, Oslo, Norway ;2.General Practice Research Unit, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway ;3.Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, Nordbyhagen, Norway ;4.HØKH, Research Centre, Akershus University Hospital, Lørenskog, Oslo, Norway |
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Abstract: | Primary chronic headaches cause more disability and necessitate high utilisation of health care. Our knowledge is based on
selected populations, while information from the general population is largely lacking. An age and gender-stratified cross-sectional
epidemiological survey included 30,000 persons aged 30–44 years. Respondents with self-reported chronic headache were interviewed
by physicians. The International Classification of Headache Disorders was used. Of all primary chronic headache sufferers,
80% had consulted their general practitioner (GP), of these 19% had also consulted a neurologist and 4% had been hospitalised.
Co-occurrence of migraine increased the probability of contact with a physician. A high Severity of Dependence Scale score
increased the probability for contact with a physician. Complementary and alternative medicine (CAM) was used by 62%, most
often physiotherapy, acupuncture and chiropractic. Contact with a physician increased the probability of use of CAM. Acute
headache medications were taken by 87%, while only 3% used prophylactic medication. GPs manage the majority of those with
primary chronic headache, 1/5 never consults a physician for their headache, while approximately 1/5 is referred to a neurologist
or hospitalised. Acute headache medication was frequently overused, while prophylactic medication was rarely used. Thus, avoidance
of acute headache medication overuse and increased use of prophylactic medication may improve the management of primary chronic
headaches in the future. |
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Keywords: | Primary chronic headache Chronic migraine Medication-overuse headache Health care utilisation General population |
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