Response rate and demographics
A total of 1000 interviews with PCP have been conducted, in 350 cases directly with the physician. Of the 1000 primary care practices from which interviews were obtained, 357 were run by internists and 643 by general practitioners (GPs). And 670 were in the German-speaking part of Switzerland, 330 in the French-speaking part. Of the 350 physicians 269 (77%) were male, 119 (34%) were internists and 231 (66%) were GPs.
Caseload and treatment behaviour
Among the 350 physicians, 92% reported that they saw at least one headache patient (i.e., a patient whose main symptom is headache) at least once per week. 23% (25% of GPs and 10% of internists) reported seeing such patients every day, 45% (47% and 40%) at least twice a week, and 24% once a week (see Figure 1).
Two-thirds of the physicians reported asking their patients actively about headache. On this item, there was a regional difference between the German- and French-speaking parts of Switzerland (53% vs. 92%), as well as a difference between specialties (74% of internists vs. 65% of GPs).
Of all the 1000 PCP surveyed, 86% reported treating patients with primary headaches (no reply to this question, 4%); the corresponding figure among the 350 physicians was 91% (no reply, 1%). Physicians who were acquainted with the SHS were slightly more likely to treat primary headache patients than those who were not (94% vs. 87%).
Specialist referral and imaging
Only a very small percentage of the directly interviewed physicians (3%) said that they would refer any patient presenting to them with headache to a specialist. On the other hand, 31% of them said they would rarely or never refer a headache patient to a specialist, even in case of treatment failure (the corresponding figure for all practices surveyed was 26%). Many physicians said they ordered MRI scans for their headache patients themselves (84% of both internists and GPs; percentage of all 1000 practices, 80%) (see Figure 1).
Awareness of the Swiss headache society and its activities
Of the 350 physicians who were directly interviewed 216 (62%) said they were acquainted with the Swiss Headache Society (SHS). This figure included 73% of the 219 German-speaking physicians, but only 44% of the 131 French-speaking physicians. 72% of the physicians who knew about the SHS (45% of all directly interviewed physicians) knew about the SHS’s treatment recommendations, 54% (33%) knew about its annual national meeting, 40% (25%) were familiar with its homepage (http://www.headache.ch), and 35% (21%) knew about its afternoon continuing medical education sessions for general practitioners.
Interest in continuing medical education and information from the SHS
A total of 255 physicians (73%) expressed an interest in further education about headache, preferring the following topics: “headache refresher” (88%), “practice-oriented workshops and case reports” (85%), “treatment of rare headaches” (76%), and “discussion of own cases with experts” (48%).
Half of the physicians gave their e-mail addresses so that they could receive further information. A total of 72% of all practices (76% of the directly interviewed physicians) ordered the service pack by mail (including treatment recommendations and homepage flyers for patients), while only 2% (1%) chose to download the material from the website instead.