Are headache patients who initiate their referral to a neurologist satisfied with the consultation? A population study of 927 patients - the North Norway Headache Study (NNHS)

Background. Headache is a common problem in primary care. Although most pat ients are treated by GPs, many are referred to specialist consultation. Kno wledge of how the referrals can be improved is therefore an important issue . Objectives. The aim of this study was to determine the relationship between self-initiating referral to a neurologist and the patient's satisfaction w ith the specialist consultation. Methods. All patients who had been examined by a neurologist for headache w ithin a 2-year period from three neurological centres in North Norway compl eted a questionnaire. Results. A total of 1052 patients from a population of 1403 headache patien ts (75%) returned the questionnaire while 927 patients answered questions a bout initiating the referral to the specialist. Two hundred and twenty pati ents (24%) initiated the referral to the neurologist themselves; 52% of tho se who self-initiated the referral were dissatisfied with the specialist co nsultation compared with 42% of those referred by the doctor, P = 0.002. Ch ronic headache, tension-type headache (TTH) and daily use of analgesic drug s were associated with dissatisfaction. Conclusions. Patients with headache who initiated the referral to a neurolo gist themselves were less satisfied with the specialist consultation. Selec ting referrals containing proper medical information may improve satisfacti on in severe headache patients treated in a neurological practice.