PRACTICE and ICPC-2 in the approach of patients affected by chronic daily headache

Abstract

Chronic daily headache (CDH) is characterized by 15 days with headache per month in the last three months. In its genesis, factors such as psychiatric comorbidities and painkillers abuse can be listed. It is important to address these factors. Objectives: To describe the use of PRACTICE and ICPC-2 in CDH and quantitatively evaluate the result of ICPC-2 coding. Methodology: Consecutive CDH patients were interviewed using PRACTICE. Seven domains, exploring the family dynamic facing the problem, compose this tool. The information obtained was coded using ICPC-2, which allows to classify the complaints in the manner they were spoken, using a biaxial system in which the organic, psychological and social systems are in the first axis and the account characteristics of are in the second one. Results: 14 patients were approached (86% women, average age 42,7 years old). The most frequent diagnosis was migraine associated to medication overuse (86%), with an illness average duration of 18,7 years, and weekly average frequency of painful episodes of 5,2 days. Conclusions: The sample characteristics were in accordance to what is found in the literature. Coding by ICPC-2 indicated known factors involved in clinical presentation maintenance. The present paper is the first using the PRACTICE tools and ICPC-2 in the approach of CDH and migraine. The authors are not aware of any previous paper describing the qualitative data coding obtained by PRATICE through ICPC-2.