The Resource Resource utilization and costs of care for treatment of chronic headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University, (electronic resource)

Resource utilization and costs of care for treatment of chronic headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University, (electronic resource)

Label
Resource utilization and costs of care for treatment of chronic headache
Title
Resource utilization and costs of care for treatment of chronic headache
Statement of responsibility
prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University
Creator
Contributor
Subject
Language
eng
Summary
  • OBJECTIVE: To identify and summarize evidence from empirical studies relating to the cost of care and the economic impact of chronic headache. SEARCH STRATEGY: We used a strategy combining the MeSH term "headache" (exploded) with terms and text words pertaining to cost and resource utilization to search the MEDLINE, HealthStar, and CINAHL databases for relevant studies published between January 1966 and December 1996. Other computerized bibliographic databases, textbooks, and experts were also utilized. SELECTION CRITERIA: We considered full reports of original empirical research, published in English, which concerned an adult (non-pediatric) subject population suffering from primary headache (i.e., not traumatic, post-lumbar puncture, or other secondary headaches), reported data relevant to the economic impact of chronic headache on medical resource utilization or work loss, and met minimal methodological criteria related to the validity of cost or utilization measures. DATA COLLECTION AND ANALYSIS: From studies of patients with primary headache, data were collected on: rates and predictors of headache-related and total health care provider consultation, emergency department utilization, hospitalization, prescription and non-prescription drug use, and work loss and disability. Data were annualized when necessary to make results of different studies more comparable. MAIN RESULTS: Of over 400 citations identified, 126 appeared to meet screening criteria, and 35 met all criteria and were included in this review. While between 56% and 91% of chronic headache sufferers seek the care of a health care provider, only one-third report having received a diagnosis of their condition. While most patients with migraine consult a health care provider at some point, most do not continue to seek medical care. Relatively fewer patients with tension-type headache seek medical care. A small sub-population of chronic headache sufferers accounts for a high proportion of provider consultations, emergency department visits, and prescription drug claims. The vast majority of headache sufferers have used drugs to treat their headaches at some time. Non-prescription drugs are used more often than prescription drugs. Patients with more severe headache symptoms are both more likely to consult a health care provider about their headaches and more likely to use prescription medications. Use of prescription drugs for headache increases with age and is higher among women than men. About two-thirds of patients who try prescription medications do not continue to use them, citing the availability of effective non-prescription drugs, unwanted side-effects, and inadequate relief among the reasons for discontinuing prescription drug use. Rates of absenteeism due to headache of 2 to 4.3 days per year were reported in employee and community studies, while higher rates, ranging from 14.3 to 61 days per year, were observed in two studies conducted in clinical settings. These average figures obscure the fact that while many to most patients miss no days of work or school, a relatively small proportion of subjects accounts for many missed days. While headache does cause a large number of absences from work, it appears that many headache sufferers stay on the job, functioning with significantly reduced effectiveness, when they have a headache. CONCLUSIONS: Chronic headache sufferers represent a diverse population which is difficult to study. Population-based studies suggest that many headache sufferers do not seek medical care for their headaches and do not use prescription drugs to treat them. Studies conducted among headache patients in clinical settings suggest that these patients have more severe headache symptoms, use more prescriptions drugs, and are heavier users of medical resources. Data from both types of studies must be considered if the comprehensive cost of chronic headache is to be estimated
  • OBJECTIVE: To identify and summarize evidence from empirical studies relating to the cost of care and the economic impact of chronic headache. SEARCH STRATEGY: We used a strategy combining the MeSH term "headache" (exploded) with terms and text words pertaining to cost and resource utilization to search the MEDLINE, HealthStar, and CINAHL databases for relevant studies published between January 1966 and December 1996. Other computerized bibliographic databases, textbooks, and experts were also utilized. SELECTION CRITERIA: We considered full reports of original empirical research, published in English, which concerned an adult (non-pediatric) subject population suffering from primary headache (i.e., not traumatic, post-lumbar puncture, or other secondary headaches), reported data relevant to the economic impact of chronic headache on medical resource utilization or work loss, and met minimal methodological criteria related to the validity of cost or utilization measures. DATA COLLECTION AND ANALYSIS: From studies of patients with primary headache, data were collected on: rates and predictors of headache-related and total health care provider consultation, emergency department utilization, hospitalization, prescription and non-prescription drug use, and work loss and disability. Data were annualized when necessary to make results of different studies more comparable. MAIN RESULTS: Of over 400 citations identified, 126 appeared to meet screening criteria, and 35 met all criteria and were included in this review. While between 56% and 91% of chronic headache sufferers seek the care of a health care provider, only one-third report having received a diagnosis of their condition. While most patients with migraine consult a health care provider at some point, most do not continue to seek medical care. Relatively fewer patients with tension-type headache seek medical care. A small sub-population of chronic headache sufferers accounts for a high proportion of provider consultations, emergency department visits, and prescription drug claims. The vast majority of headache sufferers have used drugs to treat their headaches at some time. Non-prescription drugs are used more often than prescription drugs. Patients with more severe headache symptoms are both more likely to consult a health care provider about their headaches and more likely to use prescription medications. Use of prescription drugs for headache increases with age and is higher among women than men. About two-thirds of patients who try prescription medications do not continue to use them, citing the availability of effective non-prescription drugs, unwanted side-effects, and inadequate relief among the reasons for discontinuing prescription drug use. Rates of absenteeism due to headache of 2 to 4.3 days per year were reported in employee and community studies, while higher rates, ranging from 14.3 to 61 days per year, were observed in two studies conducted in clinical settings. These average figures obscure the fact that while many to most patients miss no days of work or school, a relatively small proportion of subjects accounts for many missed days. While headache does cause a large number of absences from work, it appears that many headache sufferers stay on the job, functioning with significantly reduced effectiveness, when they have a headache. CONCLUSIONS: Chronic headache sufferers represent a diverse population which is difficult to study. Population-based studies suggest that many headache sufferers do not seek medical care for their headaches and do not use prescription drugs to treat them. Studies conducted among headache patients in clinical settings suggest that these patients have more severe headache symptoms, use more prescriptions drugs, and are heavier users of medical resources. Data from both types of studies must be considered if the comprehensive cost of chronic headache is to be estimated
Member of
Cataloging source
DNLM
http://library.link/vocab/creatorName
Archibald, Nancy
Funding information
Prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University.
NLM call number
WL 342
http://library.link/vocab/relatedWorkOrContributorName
  • Lipscomb, Joseph
  • McCrory, Douglas C
  • Duke University
  • United States
Series statement
Technical reviews
Series volume
no. 2.1
http://library.link/vocab/subjectName
  • Headache Disorders
  • Headache Disorders
  • Empirical Research
  • Health Care Costs
  • Health Services
  • United States
  • United States
Label
Resource utilization and costs of care for treatment of chronic headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University, (electronic resource)
Instantiates
Publication
Note
  • Title from PDF title page
  • "February 1999."
  • "Contract no. 290-94-2025."
  • "Contributing authors, Nancy Archibald, Joseph Lipscomb, Douglas C. McCrory."
Bibliography note
Includes bibliographical references
Control code
OCM1bookssj0000996378
Dimensions
unknown
Governing access note
License restrictions may limit access
Specific material designation
remote
System control number
(WaSeSS)ssj0000996378
System details
Mode of access: Internet
Label
Resource utilization and costs of care for treatment of chronic headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University, (electronic resource)
Publication
Note
  • Title from PDF title page
  • "February 1999."
  • "Contract no. 290-94-2025."
  • "Contributing authors, Nancy Archibald, Joseph Lipscomb, Douglas C. McCrory."
Bibliography note
Includes bibliographical references
Control code
OCM1bookssj0000996378
Dimensions
unknown
Governing access note
License restrictions may limit access
Specific material designation
remote
System control number
(WaSeSS)ssj0000996378
System details
Mode of access: Internet

Library Locations

    • Thomas Jefferson LibraryBorrow it
      1 University Blvd, St. Louis, MO, 63121, US
      38.710138 -90.311107
Processing Feedback ...