Sharp Increase in Advanced Imaging Exams and Referrals for Patients with Headaches

Medical guidelines in the United States recommend lifestyle counseling as preferred treatment for patients complaining of headaches. However, despite this advice, a study published in the January 8, 2015, issue of Journal of General Internal Medicine has found a sharp increase in prescriptions of preventive medications, referrals to other doctors, and for Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).

The study compared how headache symptoms were dealt with during 9,362 doctor's visits (representing 144 million doctors’ visits from the year 1999 to 2010). The mean age of the patients was 46 years, and the gender was predominantly female (nearly 75%).

The researchers from the Harvard Medical School (HMS; Boston, MA, USA), Beth Israel Deaconess Medical Center (BIDMC; Boston, MA, USA), and the Massachusetts General Hospital (Boston, MA, USA) used a US nationally-representative sample of clinician visits for headaches provided by US National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), excluding trauma, cancer, and visits in cases of neurological deficit.

The researchers found a nearly twofold increase from 8.5% to 15.9% in prescriptions of preventive medications in 2009–2010 compared to 1999–2000, an increase of physician referrals from 6.9% to 13.2%, and an increase in the use of CT/MRI from 6.7% to 13.9%.

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