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The long and winding road: the journey taken by headache sufferers in search of help

AIM: To outline the pathways a cohort of first attendees to our headache clinics had taken over the years in search of explanations and treatment for their headaches. To establish a greater awareness of the shortcomings and failures in their medical journey in the hope that better headache managemen...

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Autores principales: Davies, Paul T.G., Lane, Russell J.M., Astbury, Theresa, Fontebasso, Manuela, Murphy, Jill, Matharu, Manjit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476391/
https://www.ncbi.nlm.nih.gov/pubmed/29848391
http://dx.doi.org/10.1017/S1463423618000324
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author Davies, Paul T.G.
Lane, Russell J.M.
Astbury, Theresa
Fontebasso, Manuela
Murphy, Jill
Matharu, Manjit
author_facet Davies, Paul T.G.
Lane, Russell J.M.
Astbury, Theresa
Fontebasso, Manuela
Murphy, Jill
Matharu, Manjit
author_sort Davies, Paul T.G.
collection PubMed
description AIM: To outline the pathways a cohort of first attendees to our headache clinics had taken over the years in search of explanations and treatment for their headaches. To establish a greater awareness of the shortcomings and failures in their medical journey in the hope that better headache management will emerge in primary care. BACKGROUND: At first attendance in primary care most headache sufferers will not receive a firm diagnosis. Treatments provided are often ineffective and so many patients embark on a somewhat random self-made journey searching for a remedy. If they reach a Headache Clinic the most common diagnoses are ‘chronic migraine’ and ‘medication overuse headache’. They are either no better or worse than when their headaches first started despite their efforts. METHOD: We undertook a prospective questionnaire-based study of over 200 patients on first attendance at each of our headache clinics, three based in District General Hospitals and one in a tertiary referral centre. We documented the patients’ headache characteristics, the ‘burden’ of their headaches, functional handicap and the financial costs incurred seeking help before referral. We also documented what our patients understood about their headache disorder and the treatments previously tried. FINDINGS: Most patients had not been given a formal diagnosis in primary care and many remained unconvinced of the benign nature of their headache problem and wanted further investigations. A few had sought help from headache charities. Many had unrealistic attitudes to their problem and medication overuse was rife. A few patients had been offered triptans in primary care. Key deficiencies in the primary care management of these patients included failure to provide a formal headache diagnosis, inadequate understanding of the nature and mechanism of headaches and failure to follow a resilient management strategy. We provide a more effective management pathway in primary care.
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spelling pubmed-64763912019-05-01 The long and winding road: the journey taken by headache sufferers in search of help Davies, Paul T.G. Lane, Russell J.M. Astbury, Theresa Fontebasso, Manuela Murphy, Jill Matharu, Manjit Prim Health Care Res Dev Research AIM: To outline the pathways a cohort of first attendees to our headache clinics had taken over the years in search of explanations and treatment for their headaches. To establish a greater awareness of the shortcomings and failures in their medical journey in the hope that better headache management will emerge in primary care. BACKGROUND: At first attendance in primary care most headache sufferers will not receive a firm diagnosis. Treatments provided are often ineffective and so many patients embark on a somewhat random self-made journey searching for a remedy. If they reach a Headache Clinic the most common diagnoses are ‘chronic migraine’ and ‘medication overuse headache’. They are either no better or worse than when their headaches first started despite their efforts. METHOD: We undertook a prospective questionnaire-based study of over 200 patients on first attendance at each of our headache clinics, three based in District General Hospitals and one in a tertiary referral centre. We documented the patients’ headache characteristics, the ‘burden’ of their headaches, functional handicap and the financial costs incurred seeking help before referral. We also documented what our patients understood about their headache disorder and the treatments previously tried. FINDINGS: Most patients had not been given a formal diagnosis in primary care and many remained unconvinced of the benign nature of their headache problem and wanted further investigations. A few had sought help from headache charities. Many had unrealistic attitudes to their problem and medication overuse was rife. A few patients had been offered triptans in primary care. Key deficiencies in the primary care management of these patients included failure to provide a formal headache diagnosis, inadequate understanding of the nature and mechanism of headaches and failure to follow a resilient management strategy. We provide a more effective management pathway in primary care. Cambridge University Press 2018-05-31 /pmc/articles/PMC6476391/ /pubmed/29848391 http://dx.doi.org/10.1017/S1463423618000324 Text en © Cambridge University Press 2018 http://creativecommons.org/licenses/by/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits nrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Davies, Paul T.G.
Lane, Russell J.M.
Astbury, Theresa
Fontebasso, Manuela
Murphy, Jill
Matharu, Manjit
The long and winding road: the journey taken by headache sufferers in search of help
title The long and winding road: the journey taken by headache sufferers in search of help
title_full The long and winding road: the journey taken by headache sufferers in search of help
title_fullStr The long and winding road: the journey taken by headache sufferers in search of help
title_full_unstemmed The long and winding road: the journey taken by headache sufferers in search of help
title_short The long and winding road: the journey taken by headache sufferers in search of help
title_sort long and winding road: the journey taken by headache sufferers in search of help
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476391/
https://www.ncbi.nlm.nih.gov/pubmed/29848391
http://dx.doi.org/10.1017/S1463423618000324
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