title: Prevalence and burden of headaches as assessed by the health family program.
abstract: BACKGROUND
  Unified health systems often have Family Health Programs (FHPs) as a core component of their preventive and early curative strategies. In Brazil, the FHP is established to proactively identify diseases such as diabetes and hypertension.
  
  
  OBJECTIVE
  To use the FHP in order to assess the prevalence of primary headaches, as per the Second Edition of the International Classification of Headache Disorders in a Brazilian city covered by the program, and to document the burden of migraine and tension-type headache (TTH) in this population.
  
  
  METHODS
  FHP agents were trained on how to apply questionnaires that screened for the occurrence of headaches in the past year. Screening method had been previously validated. Respondents that screened positively were interviewed by a headache specialist, and all their headache types were classified. Additionally, disability (Migraine Disability Assessment Scale and Headache Impact Test) and health-related quality of life were assessed.
  
  
  RESULTS
  The 1-year prevalence of migraine was 18.2% [95% confidence interval = 13.7; 23.5]. TTH occurred in 22.9% [18.0%; 28.6%]. Other primary headaches occurred in 10.8% of the participants. Idiopathic stabbing headache was significantly more common in individuals with migraine relative to those without migraine (44.7% vs 10.3%, P < .001). Contrasting with TTH, migraineurs had a mean of 3.1 headache types vs 1.9 in TTH (P < .001). Secondary headaches occurred in 21.7% of the participants over a 1-year period [16.9%; 27.3%]. Most cases were headaches attributed to infection (mostly respiratory). The impact of migraine was bimodal. Most sufferers had little impact, but a sizable minority was severely impaired.
  
  
  CONCLUSIONS
  The FHP can be effectively used to bring individuals with headache to the attention of providers. Future investigations should assess whether this increased attention translates into improved outcomes.
authors.affiliation: Headache Clinic, UFMG, Belo Horizonte, Brazil. ariovaldo.junior@unifenas.br
authors.forename: Ariovaldo A
authors.initials: AA
authors.lastname: Silva Junior
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bigal
authors.forename: Luiz P B
authors.initials: LP
authors.lastname: Vasconcelos
authors.forename: Joismar
authors.initials: J
authors.lastname: Rodrigues
authors.forename: Rodrigo S
authors.initials: RS
authors.lastname: Gomez
authors.forename: Abouch V
authors.initials: AV
authors.lastname: Krymchantowski
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreira Filho
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Teixeira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D018672:Community Health Planning; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019370:Observation; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult