Conflict of Interest: None
Prevalence and Burden of Headaches as Assessed by the Health Family Program
Article first published online: 21 FEB 2012
© 2012 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 52, Issue 3, pages 483–490, March 2012
How to Cite
Silva Junior, A. A., Bigal, M., Vasconcelos, L. P. B., Rodrigues, J., Gomez, R. S., Krymchantowski, A. V., Moreira Filho, P. and Teixeira, A. L. (2012), Prevalence and Burden of Headaches as Assessed by the Health Family Program. Headache: The Journal of Head and Face Pain, 52: 483–490. doi: 10.1111/j.1526-4610.2012.02090.x
- Issue published online: 8 MAR 2012
- Article first published online: 21 FEB 2012
- Accepted for publication November 16, 2011.
Vol. 52, Issue 5, 861, Article first published online: 13 APR 2012
Background.— Unified health systems often have Family Health Programs (FHPs) as a core component of their preventive and early curative strategies. In Brazil, the FHP is established to proactively identify diseases such as diabetes and hypertension.
Objective.— To use the FHP in order to assess the prevalence of primary headaches, as per the Second Edition of the International Classification of Headache Disorders in a Brazilian city covered by the program, and to document the burden of migraine and tension-type headache (TTH) in this population.
Methods.— FHP agents were trained on how to apply questionnaires that screened for the occurrence of headaches in the past year. Screening method had been previously validated. Respondents that screened positively were interviewed by a headache specialist, and all their headache types were classified. Additionally, disability (Migraine Disability Assessment Scale and Headache Impact Test) and health-related quality of life were assessed.
Results.— The 1-year prevalence of migraine was 18.2% [95% confidence interval = 13.7; 23.5]. TTH occurred in 22.9% [18.0%; 28.6%]. Other primary headaches occurred in 10.8% of the participants. Idiopathic stabbing headache was significantly more common in individuals with migraine relative to those without migraine (44.7% vs 10.3%, P < .001). Contrasting with TTH, migraineurs had a mean of 3.1 headache types vs 1.9 in TTH (P < .001). Secondary headaches occurred in 21.7% of the participants over a 1-year period [16.9%; 27.3%]. Most cases were headaches attributed to infection (mostly respiratory). The impact of migraine was bimodal. Most sufferers had little impact, but a sizable minority was severely impaired.
Conclusions.— The FHP can be effectively used to bring individuals with headache to the attention of providers. Future investigations should assess whether this increased attention translates into improved outcomes.
[Correction added after online publication 21-Feb-2012: The original publication contained an incorrect abstract. The above content replaces the abstract found in the originally published article.]