Referrals from primary care to a dedicated headache clinic: analysis of the first 1,000 patients

Introduction. It is commonplace practice in dedicated clinics or headache units to deal with complex patients referred from general neurology clinics. In our centre, part of the schedule of the dedicated headache clinic (DHC) is reserved for patients referred from primary care (PC) in the form of one-stop clinics. Aims. To analyse both the characteristics of the patients referred by PC to DHC and the suitability of the agreed referral criteria, and to compare them with the first visits due to headache in a general neurology clinic. Patients and methods. The study was conducted on a sample of 1,000 patients (741 females and 259 males) in the DHC and 290 (203 females and 87 males) in the general clinic. Data were collected retrospectively and included demographic variables, previous use of symptomatic or preventive treatments, need for complementary examinations and adjustment to referral criteria. Headaches were coded in accordance with the second edition of the International Headache Classification (IHC-2). Results. A total of 1,562 headaches were coded in the DHC group and 444 in the general clinic group; their distribution over the groups of the IHC-2 was similar, and most of them fell into group 1 (migraine). The percentage of patients who had received preventive treatment was higher in the DHC. The percentage of appropriate referrals was high and a little higher still in the general clinic. Conclusions. The characteristics of the patients referred from PC to a DHC in our milieu were similar to those reported in previous studies. These patients have received treatment more frequently than those who were seen in a general neurology clinic.