Clinical practice of Headache: The Patient’s Education

Abstract

Introduction: Headache is the commonest reason for neurology referrals, and the commonest neurological reason for patients attending Emergency Departments (EDs). An ethical approach to health care requires that patients be provided with informed choice about management. However researchers have not addressed patients’ concerns and choices in managing headache. This study aims to describe the views of patients, their fears, use of EDs, their perceived need for a scan and its outcome for them. Methods: A qualitative study using semi-structured interviews with 19 adults aged 23-63, referred by Family Practitioners (FPs) to neurologists for primary headaches approximately two years previously. Audio-recorded interviews were transcribed and analysed thematically. Results: Participants described fears about secondary organic causes for headache, like a brain tumor. They described their headaches as stressful, and leading to a vicious cycle of fear. Many believed they needed a brain scan and requested it. Participants reported relief of their fears after a scan, and in some cases relief of headache symptoms. Discussion: UK FPs now have open access to brain scanning, which may relieve physical concerns. Interventions to address health-related anxiety may also help some consulters for headache.