Knowledge of the medical resident about diagnosis and treatment of patients with headache
DOI:
https://doi.org/10.48208/HeadacheMed.2022.33Keywords:
Headache, Care, Treatment, Symptoms, MigraineAbstract
Introduction
Considering the high prevalence of headache, it is necessary a study about the effectiveness of the care of patients with headache by medical resident in Emergency Care Units (EDU) and medical outpatient clinics.
Objective
The objective of this study was to analyze the effectiveness of care in EDUs, outpatient clinics and medical wards and the management of patients with headache complaints.
Method
The study was observational descriptive (cross-sectional cohort) through the application of an online questionnaire answered by the medical residents.
Results
There were 115 residents who answered the survey. In the group of residents who see patients with headache (n=95) the number of visits was 4.87 per week. The resident's idea is that headaches are symptoms of an underlying disease in 49.5% of them. On the question about feeling able to differentiate primary from secondary headaches, 50% of the residents said yes. On the question, "Is Migraine the same as Headache?" 6.1% answered yes. On the question, "Would you use morphine derivatives to treat headache?" 19.1% of the residents answered that they would. On the question about having knowledge about the harms of using morphine derivatives in headache, 60% answered that they did not have in-depth knowledge or that they have no knowledge. In this sample of residents, 74/115 (65%) suffer from headache. Only 36/115 (31%) of the residents sought care because of the headache. Of the residents, 3/115 (2.6%) have chronic daily headache. In the question about knowing what is "chronic daily headache" and from medication overuse, about 35% do not know or did not delve into the concept.
Conclusion
We conclude that there is a lack of teaching about types of headaches, criteria for diagnosis and treatment. Urgent modifications should be made in the medical course to enable newly graduated doctors to diagnose and treat patients with headache.
Downloads
References
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1-211 Doi:10.1177/0333102417738202 DOI: https://doi.org/10.1177/0333102417738202
Bigal ME, Bordini CA and Speciali JG. Tratamento da cefaléia em uma unidade de emergência da cidade de Ribeirão Preto. Arq Neuropsiquiatr 1999;57:813-819 Doi:10.1590/S0004-282X1999000500013 DOI: https://doi.org/10.1590/S0004-282X1999000500013
Bigal ME and Speciali JG. Cefaléia em uma unidade de emergência de atendimento terciário, aspectos epidemiológicos, clínicos, terapêuticos e dos custos do atendimento hospitalar. Ribeirão Preto: Universidade de São Paulo; 2000.
Speciali JG, Kowacs F, Jurno ME, Bruscky IS, de Carvalho JJF, Malheiro FG, . . . Pires DBF. Protocolo nacional para diagnóstico e manejo das cefaleias nas unidades de urgência do brasil-2018. Acad Bras Neurol 2018;205:1-11
Filler L, Akhter M and Nimlos P. Evaluation and Management of the Emergency Department Headache. Semin Neurol 2019;39(1):20-26 Doi:10.1055/s-0038-1677023 DOI: https://doi.org/10.1055/s-0038-1677023
Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, . . . Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr 2016;74(3):262-271 Doi:10.1590/0004-282x2015021 DOI: https://doi.org/10.1590/0004-282X2015021
Stovner LJ, Hagen K, Linde M and Steiner TJ. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain 2022;23(1):34 Doi:10.1186/s10194-022-01402-2 DOI: https://doi.org/10.1186/s10194-022-01402-2
Sakai F, Hirata K, Igarashi H, Takeshima T, Nakayama T, Sano H, . . . Koga N. A study to investigate the prevalence of headache disorders and migraine among people registered in a health insurance association in Japan. J Headache Pain 2022;23(1):70 Doi:10.1186/s10194-022-01439-3 DOI: https://doi.org/10.1186/s10194-022-01529-2
Dhiman V, Menon GR, Kaur S, Mishra A, John D, Rao Vishnu MV, . . . Dhaliwal RS. A Systematic Review and Meta-analysis of Prevalence of Epilepsy, Dementia, Headache, and Parkinson Disease in India. Neurol India 2021;69(2):294-301 Doi:10.4103/0028-3886.314588 DOI: https://doi.org/10.4103/0028-3886.314588
Al Jumah M, Al Khathaami AM, Kojan S, Hussain M, Thomas H and Steiner TJ. The prevalence of primary headache disorders in Saudi Arabia: a cross-sectional population-based study. J Headache Pain 2020;21(1):11 Doi:10.1186/s10194-020-1081-1 DOI: https://doi.org/10.1186/s10194-020-1081-1
Burch R, Rizzoli P and Loder E. The prevalence and impact of migraine and severe headache in the United States: Updated age, sex, and socioeconomic-specific estimates from government health surveys. Headache 2021;61(1):60-68 Doi:10.1111/head.14024 DOI: https://doi.org/10.1111/head.14024
Shrestha O, Karki S, Thapa N, Lal Shrestha K, Shah A, Dhakal P, . . . Shrestha DB. Prevalence of migraine and tension-type headache among undergraduate medical students of Kathmandu Valley: A cross-sectional study. Health Sci Rep 2022;5(5):e747 Doi:10.1002/hsr2.747 DOI: https://doi.org/10.1002/hsr2.747
Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, . . . Hershey AD. Prevalence of Headache Days and Disability 3 Years After Participation in the Childhood and Adolescent Migraine Prevention Medication Trial. JAMA Netw Open 2021;4(7):e2114712 Doi:10.1001/jamanetworkopen.2021.14712 DOI: https://doi.org/10.1001/jamanetworkopen.2021.14712
Wilkes MJ, Mendis MD, Bisset L, Leung FT, Sexton CT and Hides JA. The prevalence and burden of recurrent headache in Australian adolescents: findings from the longitudinal study of Australian children. J Headache Pain 2021;22(1):49 Doi:10.1186/s10194-021-01262-2 DOI: https://doi.org/10.1186/s10194-021-01262-2
Genc D, Vaičienė-Magistris N, Zaborskis A, Şaşmaz T, Tunç AY, Uluduz D and Steiner TJ. The prevalence of headache disorders in children and adolescents in Lithuania: a schools-based study. J Headache Pain 2020;21(1):73 Doi:10.1186/s10194-020-01146-x DOI: https://doi.org/10.1186/s10194-020-01146-x
Patel UK, Malik P, Shah D, Sharma A, Bhela J, Chauhan B, . . . Kavi T. The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study. Cureus 2020;12(8):e9743 Doi:10.7759/cureus.9743 DOI: https://doi.org/10.7759/cureus.9743
Miller J, Koons L and Longyhore D. Opioid free treatment algorithm for ED headache management: Effect on revisit rate. Am J Emerg Med 2020;38(1):28-32 Doi:10.1016/j.ajem.2019.03.053 DOI: https://doi.org/10.1016/j.ajem.2019.03.053
Pellatt RAF, Kamona S, Chu K, Sweeny A, Kuan WS, Kinnear FB, . . . Kelly AM. The Headache in Emergency Departments study: Opioid prescribing in patients presenting with headache. A multicenter, cross-sectional, observational study. Headache 2021;61(9):1387-1402 Doi:10.1111/head.14217 DOI: https://doi.org/10.1111/head.14217
Kommineni M and Finkel AG. Teaching headache in America: survey of neurology chairs and residency directors. Headache 2005;45(7):862-865 Doi:10.1111/j.1526-4610.2005.05154.x DOI: https://doi.org/10.1111/j.1526-4610.2005.05154.x
Kumar KL and Joos SK. Teaching headache management to medicine residents. Headache 1996;36(7):446-447 Doi:10.1046/j.1526-4610.1996.3607446.x DOI: https://doi.org/10.1046/j.1526-4610.1996.3607446.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Sophia Orsi, Eliana Meire Melhado, Bárbara Aparecida Klafke Zambelli, Beatriz Andrade Paternost, José Henrique Fetti Farina, Sarah Gavião Ferreira, Tarso Vieira Cavalcanti Albuquerque
This work is licensed under a Creative Commons Attribution 4.0 International License.
