Headache study: The management of chronic headache with referral from primary care to direct access to Magnetic Resonance Imaging (MRI) compared to Neurology services: an observational prospective study in London

Objectives. To evaluate the cost, accessibility and patient satisfaction implications of two clinical pathways used in the management of chronic headache.

Intervention. Management of chronic headache following referral from Primary Care that differed in the first appointment, either a Neurology appointment or an MRI brain scan.

Design and setting. A pragmatic, non-randomised, prospective, single-center study at a Central Hospital in London.

Participants. Adult patients with chronic headache referred from Primary to Secondary Care.

Primary and secondary outcome measures. Participants’ use of health care services and costs were estimated using primary and secondary care databases and questionnaires quarterly up to 12 months post-recruitment. Cost analyses were compared using generalised linear models (GLM). Secondary outcomes assessed: access to care, patient satisfaction, headache burden and self-perceived quality of life using headache-specific (MIDAS, HIT-6) and a generic q...