Can patients who apply to tertiary care with headache for the first time be managed in primary care? - a cross-sectional study
Can patients who apply to tertiary care with headache for the first time be managed in primary care? - a cross-sectional study
Background/aim: Headaches are one of the most common neurological symptoms. They adversely affect daily life, reduces the workforce, and have high health costs. Managing this symptom in primary care will free up secondary and tertiary health services to better treat patients who need follow-up by specialists. In the present study, we aim to show the rate at which this problem can be solved in primary care for patients who applied tertiary care services with a headache for the first time. Materials and methods: Our research is a cross-sectional study of 207 patients who applied to the neurology clinics for the first time with headache. Two questionnaires were prepared by the researchers. IBM SPSS v: 21.0 was used for statistical analysis, and the level of significance was p < 0.05. Results: The opinions of the patients on the evaluability of headache in primary care were compared. Family physicians and neurologists gave similar responses about the disease management, at a rate of 96.6%, this was found to be statistically significant and shows strong agreement. Both groups of physicians thought that 70% of patients, on average, who applied to the neurology clinics with headache for the first time could be managed in primary care. However, only 9.2% of the patients share this opinion with physicians. Primary headache cases constitute most of the cases that are thought to be solved in primary care. It was revealed that the number of patients seeking primary care with this complaint was lower than expected. Conclusion: Patients with headache applied tertiary care instead of primary care for different reasons. Both neurologists and family physicians stated that most patients evaluated in tertiary care could be managed in primary care.Key words: Primary care, headache, family physician
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- 1. Olesen J. Headache Classification Committee of the International Headache Society (IHS) the international classification of headache disorders, 3rd edition. Cephalalgia. 2018; 38 (1): 1-211. doi/10.1177/0333102417738202
- 2. Rasmussen B. Epidemiology of headache. Cephalalgia. 1995; 15 (1): 44-67. doi/10.1046/j.1468-2982.1995.1501045.x
- 3. Robbins MS, Lipton RB. The epidemiology of primary headache disorders. Seminars in Neurology. 2010; 30 (2): 107- 119. doi: 10.1055/s-0030-1249220
- 4. Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: headache. Canadian Family Physician. 2007; 53 (10): 1733.
- 5. Kernick D, Stapley S, Hamilton W. GP’s classification of headache: Is primary headache underdiagnosed? British Journal of General Practice 2008; 58 (547): 102-104. doi: 10.3399/bjgp08X264072
- 6. Baykan B. Başağrıları ve diğer kranyofasyal ağrılar. In: Emre M, (editor). Nöroloji Temel Kitabı. Ankara: Güneş Tıp Kitapevleri; 2013. pp. 131-132 (in Turkish).
- 7. Robbins MS, Lipton RB. The epidemiology of primary headache disorders. Seminars in Neurology. 2010; 30 (2): 107- 119. doi: 10.1055/s-0030-1249220
- 8. Aksel S. Baş ağrısı epidemiyolojisi. In: İÜ Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri. Istanbul, Turkey, 2002. pp. 9-14 (in Turkish).
- 9. Durmuş H, Timur A, Yıldız S, Çetinkaya F. The satisfaction of the people about family medicine who admitted to outpatient clinics of Erciyes University Hospital. Türk Aile Hekimliği Dergisi. 2018; 22 (1): 2-11 (in Turkish). doi: 10.15511/ tahd.18.00102
- 10. Ayazoğlu C. Ankara Şehir Hastanesi’ne başvuran hastaların aile hekimlerine bakışı, MD, Ankara Şehir Hastanesi, Ankara, Turkey, 2020 (in Turkish).
- 11. Lenaerts ME. Alternative therapies for tension-type headache. Current Pain and Headache Reports 2004; 8 (6): 484-488. doi: 10.1007/s11916-004-0071-3
- 12. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G et al. EFNS guideline on the treatment of tension-type headache-report of an EFNS task force. European Journal of Neurology 2010; 17 (11): 1318-1325. doi: 10.1111/j.1468- 1331.2010.03070.x
- 13. Berberoglu U, Eskiocak M. Edirne Devlet Hastanesi’nin kimi polikliniklerinde verilen birinci basamak saglık hizmetlerinin boyutları. Toplum ve Hekim. 2000; 3 (15): 199 (in Turkish).
- 14. Güven EA, Aycan S. Ankara’da bir üniversite hastanesine başvuranların mevcut aile hekimliği sistemi ve sevk uygulaması hakkında düşünceleri. ESTÜDAM Halk Sağlığı Dergisi. 2018; 3 (3): 1-11 (in Turkish).
- 15. Ay H, İnanç Y, Doğantürk T, Kocatürk Ö. Nöroloji polikliniğine baş ağrısı yakınması ile başvuran hastalarda kraniyal manyetik rezonans görüntüleme (mrg) tetkiki istenmeli midir ? Fırat Tıp Dergisi 2015; 20 (2): 92-95 (in Turkish).
- 16. Holle D, Obermann M. The role of neuroimaging in the diagnosis of headache disorders. Therapeutic Advances in Neurological Disorders 2013; 6 (6): 369-374. doi: 10.1177/1756285613489765
- 17. Demir MC. Radyolojik görüntüleme isterken doktorların göz önünde bulundurdukları durumlar, MD, Hacettepe University, Ankara, Turkey, 2016 (in Turkish).
- 18. Yıldız N. Ankara’da üçüncü basamak bir eğitim ve araştırma hastanesinin kulak burun boğaz fizik tedavi ve rehabilitasyon ile dermatoloji polikliniklerine başvuran hastaların birinci basamakta takip ve tedavi edilebilirliğinin araştırılması, MD, Ankara Numune Training and Research Hospital, Ankara, Turkey, 2016 (in Turkish).