MRC Cohort study High impact, disability, and emotional distress

1. GP headache consulters & referred4% of adults pa consult GPs for headache97% managedby GPs, 2% referred to neurologists Latinovic et al: JNNP 200525% of referrals to neurologists for headacheRidsdale et al: ABN 2005/11 MRC Cohort study High impact, disability, and emotional distress No difference in these clinical characteristics between GP consulters and those referredRidsdale et al: BJGP2007

2. Headache impact, satisfaction & cost in hospital & in GPwSI clinicsHeadache impact no different in those referred to hospital & GPwSI clinics Patient satisfaction with clinics Hospital 72% of maximum, GPwSI 79% (p=0.002) waiting time, access, being listened to & understood, help they had received, extent to which their needs were met, relieving their symptoms, ability to deal more effectively with their problems, overall more agreed:- it is ‘the kind of service they wanted.’ • CostsGPwSI service less costly £150 vs £200 pp • Ridsdale et al BJGP 2008

3. GP headache consulters & referred are different GPs views- why they refer ‘ultimately they (patients) say that's all very interesting and thank you very much for the time you've taken, but I still want to see someone …’ ‘everybody feels they need a scan — as soon as they've got a headache they feel they need a scan’ Morgan et al BJGP 2007, Ridsdale et al BJGP 2007 ‘