Evaluation of patients presenting with headache to the emergency outpatient clinic

Abstract

Aims: This study aimed to explore the factors contributing to headache presentation in patients by recognizing headache as a symptom of various potential ailments. It is crucial to understand these factors for appropriate assessment and treatment planning in patients with headaches. Additionally, this study investigated patients' preferences for headache management, which is an understudied aspect in the field. Methods: In 2012, a two-month study was conducted at an emergency department outpatient clinic to assess the general characteristics, severity, frequency, duration, and location of headache episodes among patients presenting with headache complaints. The study analyzed various parameters, including the different types of pain, such as throbbing, stabbing, and burning, as well as the impact of headaches on daily performance, medication use, specific medications taken, and alternative treatment methods via a headache questionnaire. Results: The survey results revealed that 21.7% of the patients described their pain as extremely severe, 52.2% as severe, and 26.1% as distressing. Pain descriptions were predominantly throbbing (79.4%) and pain (62.2%), with sensations of pressure (20%), stabbing (18.3%), pulsating (13.3%), burning (10.6%), and constriction-like a band (2.8%). The localization of pain was bilateral in 15.0% of patients, unilateral in 18.3%, around or behind the eyes in 28.3%, and in the neck or back of the head in 38.3%. Headaches were found to affect the work life of 40.6% of patients, 20% reported no impact, and 39.4% experienced occasional interference. No significant statistical difference was observed regarding the intensity, frequency, and duration of pain, and its impact on work life with respect to sex. The usage of non-prescription medication was high (92.8 %), whereas prescription medication usage was 57.8%. Regarding alternative treatment methods, massage therapy was used by 53.6% of the patients and herbal treatments by 17.8%. Conclusion: This study examined the frequency and handling of headaches among patients visiting an emergency department. The results indicate that headaches affect both sexes equally, with a marginal prevalence in females. To provide better care, addressing patients’ preferences and experiences is important. As patients rely on non-prescription medications and alternative therapies, concerns regarding healthcare accessibility arise. A combination of medication management, patient education, and non-pharmacological therapies is necessary to achieve better outcomes and decrease the burden on healthcare systems.