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Study of the diagnostic agreement on headaches between neurology and primary care

S. Santos-Lasaosa, P. Vinueza-Buitrón, A. Velázquez-Benito, C. Iñíguez-Martínez, P. Larrodé-Pellicer, L.J. López del Val, J.A. Mauri-Llerda, S. Sánchez-Valiente, J.L. Millán-Morales [REV NEUROL 2016;62:549-554] PMID: 27270676 DOI: https://doi.org/10.33588/rn.6212.2015495

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Volumen 62 | Number 12 | Nº of views of the article 7.020 | Nº of PDF downloads 412 | Article publication date 16/06/2016

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ABSTRACT

INTRODUCTION Headache as a symptom is a very common disease and one of the main reasons for consultation in primary care.

AIM To analyze the characteristics of patients referred from primary care to general neurology whose chief complaint was headache and/or neuralgia and diagnostic agreement.

PATIENTS AND METHODS Cross-sectional study of all patients referred from primary care; demographic/clinical variables were collected and diagnostic hypothesis by primary care and general neurology were compared by determining their agreement.

RESULTS 2,514 were referred from primary care patients (588 of them on a preferential basis); in 378 cases the reason for consultation was headache and/or neuralgia (average 42.46 years; 77.8% female). In 139 patients it was established only a semiological diagnostic and other episodic migraine predominated (49.79%), chronic tension headache (18.41%) and trigeminal neuralgia (12.13%). Since general neurology, the most common diagnoses were, respectively, 33.86%, 24.05% and 18.67%. A compatible kappa coefficient of 0.543 (p < 0.05) with a moderate agreement when considering only those patients referred from primary care to a specific diagnosis was obtained.

CONCLUSIONS Headaches are a very common reason for consultation in primary care (15%). The diagnostic agreement is moderate in our health sector so it is necessary to design training programs to help outline the criteria for referral to specialists and improve care for our patients. KeywordsDiagnostic agreement Headache Healthcare level Migraine Primary care Referral criteria CategoriesCefalea y Migraña Dolor

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Study of the diagnostic agreement on headaches between neurology and primary care

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