Knowledge About and Use of Pharmacological and Non-pharmacological Headache Therapies

Objective: To analyse knowledge and use of pharmacological and non-pharmacological therapies in headache patients referred to a tertiary headache centre.

Methods: We included 114 consecutive patients referred by a neurologist and asked them to fill out a comprehensive questionnaire immediately before their first appointment at our outpatient headache clinic. The questionnaire covered 23 compounds for acute treatment, 21 prophylactic drugs, and 30 complementary and alternative treatments.

Results: The proportion of patients who knew at least one acute therapy stood at 92 %; 62 % knew at least one pharmaco-prophylaxis and 80 % knew at least one non-pharmacological treatment. Even though 87 % of the patients with migraine had ³ 4 disabling headache days per month, only 41 % had used triptans and not more than 19 % had taken drugs of first choice for migraine prophylaxis for at least 3 months. In contrast, 75 % had used complementary or alternative treatments. Univariate analyses showed several predictors for the use of pharmaco-prophylaxis and non-pharmacological treatment, of which only knowledge about pharmaco-prophylaxis predicted use of alternative treatments in multivariate analysis.

Conclusion: In Austria, a significant proportion of patients suffering from frequent recurrent headaches or migraines who are referred to a tertiary headache centre do not know and do not use triptans and pharmacological prophylaxis, while there is obviously broad acceptance and frequent use of mostly questionable alternative treatments. Improvement of primary and secondary care as well as patient education is desirable.