Frequency and predictors of physician consultations for headache

We conducted a population-based headache questionnaire survey including questions on physician consultation for headache in Taipei, Taiwan from August 1997 to June 1998. The participants comprised 3377 subjects aged ≥ 15 years, of whom 328 (9.7%) had a diagnosis of migraine and 1754 (52%) had a diagnosis of non-migraine headache. Migraineurs had a higher physician consultation rate (once or more in the past year) than the subjects with non-migraine headache (54% vs. 31%, P<0.0001). When frequency ≥ 10 times was taken as 10 times, the analysis showed that migraineurs consulted physicians more often than non-migraine headache subjects (2.36 vs. 0.96, P=0.04). A small proportion of the subjects with either migraine (12%) or non-migraine headache (6%) accounted for 50% of total consultations within their groups. In addition to old age, low education levels, living in a rural area, migrainous features (nausea and photophobia), and work day loss, predictors of physician consultations also included 'having been troubled with headache' (odds ratio (OR)= 1.7) and co-morbidity with hypertension (OR=1.8) or heart disease (OR=2.2). Low copayment and unrestricted access to medical care, as well as cultural factors played an important role in the high consultation rates in our headache subjects. Moreover, this study found self-perception of headache impact and co-morbid illnesses were important factors affecting the decision to consult physicians about headache.