Management of secondary chronic headache in the general population: the Akershus study of chronic headache

BACKGROUND: The prevalence of secondary chronic headache in our population is 0.5%. Data is sparse on these types of headache and information about utilisation of health care and medication is missing. Our aim was to evaluate utility of health service services and medication use in secondary chronic headache in the general population. METHODS: An age and gender stratified cross-sectional epidemiological survey included 30,000 persons 30–44 years old. Diagnoses were interview-based. The International Classification of Headache Disorders 2(nd) ed. was applied along with supplementary definitions for chronic rhinosinusitis and cervicogenic headache. Secondary chronic headache exclusively due to medication overuse was excluded. RESULTS: One hundred and thirteen participants had secondary chronic headache. Thirty % had never consulted a physician, 70% had consulted their GP, 35% had consulted a neurologist and 5% had been hospitalised due to their secondary chronic headache. Co-occurrence of migraine or medication overuse increased the physician contact. Acute headache medication was taken by 84% and 11% used prophylactic medication. Complementary and alternative medicine was used by 73% with the higher frequency among those with than without physician contact. CONCLUSION: The pattern of health care utilisation indicates that there is room for improving management of secondary chronic headache.