Chronic daily headache in a primary care population: prevalence and headache impact test scores

Headache. 2007 Jan;47(1):7-12. doi: 10.1111/j.1526-4610.2007.00647.x.


Background: Population-based surveys estimate the prevalence of chronic daily headache (CDH) in the general community to be approximately 4%. The prevalence of CDH among patients seen in the primary care setting in the United States, however, is unknown.

Purpose: To estimate the prevalence and associated burden of suffering of CDH in a primary care patient population.

Methods: Cross-sectional survey of a randomly selected sample of 1500 adult patients in an academic Family Medicine Center was done. Outcome measures include self-reported headache frequency and Headache Impact Test scores.

Results: Completed questionnaires were returned by 853 (57%) patients. The mean age of respondents was 49 years (SD = 16), with a range of 18 to 94 years. Two hundred ninety-six (58%) patients reported having had 1 or more severe headaches in the past month. Seventy-four (9%) patients reported a frequency of headache consistent with CDH, defined as the occurrence of headache 15 or more days in the past month. Twenty-four patients (32%) with CDH either believed that none of their doctors know that they experienced headaches or were not sure if their doctors were aware of their headaches, and 21 (28%) reported that they have not needed a doctor's care for their headaches.

Conclusions: The prevalence of CDH is greater among a primary care patient population compared to the general community. A substantial proportion of patients with CDH do not bring their headaches to the attention of their health-care providers. In light of the advances in the development of effective medications for migraines and the growing body of evidence implicating medications as a contributing cause of CDH, it may be appropriate to encourage patients to inform their health-care providers about their headaches and to encourage providers to identify patients with frequent headaches.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Headache Disorders / epidemiology*
  • Headache Disorders / physiopathology*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations
  • Prevalence
  • Primary Health Care / statistics & numerical data*
  • Severity of Illness Index*
  • United States / epidemiology