Non-Compliance With Follow-Up and Improvement After Treatment at a Headache Center

Authors

  • Egilius L.H. Spierings M.D., Ph.D.,

    Corresponding author
    1. Headache Section, Division of Neurology, Brigham and Women's Hospital; Department of Neurology, Harvard Medical School, Boston, Massachusetts
      Dr. E.L.H. Spierings, Director, Headache Section Division of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
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  • Lucia F. Miree M.P.H., Ph.D.

    1. School of Business and Management, Health Care Management Program, University of West Virginia College of Graduate Studies, Institute, West Virginia
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Dr. E.L.H. Spierings, Director, Headache Section Division of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115

Abstract

SYNOPSIS

Two telephone surveys were conducted at a major headache center into patient compliance with follow-up end perceived treatment efficacy. The first survey addressed compliance with the recommendation to follow-up after the initial evaluation. Of a group of 316 consecutive patients, 40.5% had not complied with the recommended follow-up visit. Reasons for the non-compliance were given by 60.3%; most frequently mentioned were dislike of the clinician seen and seeking care elsewhere.

The second survey concerned 75 patients who had returned at least once to the center for follow-up. When asked about the efficacy of the treatment received, 76.0% reported improvement of their headaches, with 32.0% reporting more than 75% improvement. In addition, 87.5% of the patients reported a decrease in the use of analgesic and/or ergotamine medications.

We conclude that treatment of chronic headache is not a priori a hopeless situation and that in the patient compliance with the recommendation to follow-up, in particular the patient-clinician relationship is a critical factor.

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