Dispersion of headache types and characteristics in patients that referred to primary care settings in Mersin

Abstract

This study was planned to determine the possible diagnoses and the variables affecting the type of headache in patients referring to health facilities in Mersin district, which provide primary health care. The instrument was a scale applied by the physicians in the facility. After the necessary permissions were taken, one medical doctor from each central primary healthcare facility was interviewed, a review of the diagnosis and differential diagnosis of headaches were made and the forms with the scale was introduced to them. Afterwards the forms were applied by these physicians. The data was evaluated by a neurologist, and the possible type of headache according to international IHS classification was determined. These results were analysed statistically and the factors affecting the type of headache were determined with regression analysis. Data from 350 patients were evaluated and 319 of these were taken for analysis. Of those patients, 37.3% had migraine-type headaches while 33.5% had tension-type headache. Of the remaining, 4.4% had headaches consistent with other types of headache while the type could not be determined in 24.8% with the present information. The analyses revealed that the risk for developing migraine is significantly higher in patients whose headaches started at an early age, females, those who smoke regularly and those who have hypertension. (p<0.05). Likewise, the risk of having tension-type headache was seen more frequently in patients who lived alone and who had an important financial problem recently (p<0.05). As a results, it was concluded that with a good in-job training and continuing medical education, 70.8% of headache patients can be evaluated, diagnosed and treated in the primary care setting. Migraine, with an important socioeconomic basis, is not diagnosed in %60 of women and %70 of men by the physician. Since the ratio of patients referring to the physician with headache complaint is very low in our country, we agree that primary health care providing health facilities should be supported in order to increase this ratio.