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Abstract
Background
General practitioners (GPs) diagnose and manage a majority of headache patients seeking health care. With the aim to understand the potential for clinical improvement and educational needs, we performed a study to investigate Norwegian GPs knowledge about headache and its clinical management.
Methods
We invited GPs from a random sample of 130 Norwegian continuous medical education (CME) groups to respond to an anonymous questionnaire survey.
Results
367 GPs responded to the survey (73% of invited CME groups, 7.6% of all GPs in Norway). Mean age was 46 (SD 11) years, with an average of 18 (SD 10) years of clinical experience. In general the national treatment recommendations were followed, while the International Classification of Headache Disorders and other international guidelines were rarely used. Overall, 80% (n = 292) of the GPs suggested adequate prophylactic medication for frequent episodic migraine, while 28% (n = 101) suggested adequate prophylactic medication for chronic tension-type headache (CTTH). Half (52%, n = 191)) of the respondents were aware that different types of acute headache medication can lead to medication-overuse headache (MOH), and 59% (n = 217) knew that prophylactic headache medication does not lead to MOH. GPs often used MRI in the diagnostic work-up. GPs reported that lack of good treatment options was a main barrier to more optimized treatment of headache patients.
Conclusion
The knowledge of management of CTTH and MOH was moderate compared to migraine among Norwegian GPs.
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1 University of Oslo, Department of General Practice, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921); Akershus University Hospital, Department of Neurology, Lørenskog, Norway (GRID:grid.411279.8) (ISNI:0000 0000 9637 455X); Oslo University Hospital, Department of Research and Innovation, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485)
2 Akershus University Hospital, Department of Neurology, Lørenskog, Norway (GRID:grid.411279.8) (ISNI:0000 0000 9637 455X)
3 University, of Copenhagen, Danish Knowledge Centre on Headache Disorders, Rigshospitalet-Glostrup, Glostrup, Denmark (GRID:grid.5254.6) (ISNI:0000 0001 0674 042X)
4 NTNU Norwegian University of Science and Technology, Department of Neuromedicine and Movement Science, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393); St. Olavs Hospital, Department of Neurology, National Advisory Unit on Headaches, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560)
5 University of Oslo, Department of Health Management and Health Economics, Institute of Health and Society, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921)
6 Akershus University Hospital, Department of Neurology, Lørenskog, Norway (GRID:grid.411279.8) (ISNI:0000 0000 9637 455X); Akershus University Hospital, Health Services Research Unit, Lørenskog, Norway (GRID:grid.411279.8) (ISNI:0000 0000 9637 455X); University of Oslo, Institute of Clinical Medicine, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921)
7 Oslo University Hospital, Department of Research and Innovation, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485); Oslo University Hospital, Department of Neurology, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485)