Current situation of diagnostics and management of patients with primary headaches in the Republic of Armenia

Introduction. Headache is one of the most common complaints of patients seeking for medical care. Headaches affect people of all ages, races, income levels, and geographical areas. They form a substantial burden on personal and social lives of patients, diminish their quality of life, and cause financial losses. The problem of headaches (primary ones, in particular) has not been previously studied in Armenia. We aimed to focus on several types of primary headaches (tension-type headache, migraine, trigeminal autonomic cephalalgias (particularly, cluster headaches). The prevalence of headaches in the adult population is 47%, however, many people do not receive proper treatment.

Objective of the study was to investigate the prevalence of different types of primary headaches (tension type, migraine, trigeminal autonomic cephalalgias), and assess quality of life of patients with headaches who sought for medical care.

Materials and methods. According to study inclusion and exclusion criteria, 150 patients with headache, who visited the Neurology Department of YSMU during the past 4 years, were selected for further analysis. All patients were asked to complete three questionnaires: (1) A questionnaire which was compiled by us based on diagnostic criteria of International Headache Society (2-nd edition and 3-rd edition beta versions), (2) Headache Impact Test, and (3) SF-36. All studied patients were examined by a neurologist.

Results. In the analyzed population, tension-type headache was found in 31% of patients, migraine — in 60% of patients, and trigeminal autonomic cephalalgias — in 9% of participants. More than the half of the analyzed patients have seen physicians before (75% of them were examined by a neurologist), and in 37% of cases there were multiple referrals to a physician.

Conclusion. Data analysis showed significant underestimation (both by patients and physicians) and misdiagnosis of primary headaches in our region, especially in respect to cluster headache. That leads to chronification of headaches, ineffective treatment, and development of medication-overuse headaches. It is necessary to increase public awareness about the possibilities of headache treatment, as well as to increase the competence of the medical specialists.