Abigail E Ramon, Kyle Possemato, Gregory P Beehler
{"title":"Headache Disorders in VHA Primary Care: Prevalence, Psychiatric Comorbidity, and Health Care Utilization.","authors":"Abigail E Ramon, Kyle Possemato, Gregory P Beehler","doi":"10.1080/08964289.2023.2249169","DOIUrl":null,"url":null,"abstract":"<p><p>Military veterans are at increased risk for headache disorders compared to the general population, yet the prevalence and burden associated with headache disorders among veterans is not yet well understood. In this electronic medical record study, we examined the prevalence of headache disorders among veterans seen in a northeastern network of Veterans Health Administration (VHA) primary care during 2017-2018. We also examined rates of psychiatric comorbidity and health care utilization of veterans with headache disorders for the year following the date of the first headache code in the medical record. Of the total population of veterans in the network, 1.3% had a headache disorder and another 3.5% had a possible headache disorder. Migraine and chronic migraine represented the majority of cases. Posttraumatic stress disorder was the most frequent psychiatric comorbidity. Having a headache disorder was associated with higher rates of primary care, neurology, pain clinic, and mental health service use but not higher rates of emergency department or Whole Health (e.g., patient-centered, holistic health services) use. Prevalence findings are comparable to those previously found among veterans, but a substantial proportion of veterans may have been misdiagnosed. Veterans with headache disorders have high rates of psychiatric comorbidity and use several types of health services at higher rates. Findings highlight the need for interdisciplinary care and further education and support for primary care providers. Primary care settings that integrate evidence-based behavioral and Whole Health services may be an optimal way of providing more holistic care for headache disorders.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"269-278"},"PeriodicalIF":2.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavioral Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08964289.2023.2249169","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Military veterans are at increased risk for headache disorders compared to the general population, yet the prevalence and burden associated with headache disorders among veterans is not yet well understood. In this electronic medical record study, we examined the prevalence of headache disorders among veterans seen in a northeastern network of Veterans Health Administration (VHA) primary care during 2017-2018. We also examined rates of psychiatric comorbidity and health care utilization of veterans with headache disorders for the year following the date of the first headache code in the medical record. Of the total population of veterans in the network, 1.3% had a headache disorder and another 3.5% had a possible headache disorder. Migraine and chronic migraine represented the majority of cases. Posttraumatic stress disorder was the most frequent psychiatric comorbidity. Having a headache disorder was associated with higher rates of primary care, neurology, pain clinic, and mental health service use but not higher rates of emergency department or Whole Health (e.g., patient-centered, holistic health services) use. Prevalence findings are comparable to those previously found among veterans, but a substantial proportion of veterans may have been misdiagnosed. Veterans with headache disorders have high rates of psychiatric comorbidity and use several types of health services at higher rates. Findings highlight the need for interdisciplinary care and further education and support for primary care providers. Primary care settings that integrate evidence-based behavioral and Whole Health services may be an optimal way of providing more holistic care for headache disorders.
期刊介绍:
Behavioral Medicine is a multidisciplinary peer-reviewed journal, which fosters and promotes the exchange of knowledge and the advancement of theory in the field of behavioral medicine, including but not limited to understandings of disease prevention, health promotion, health disparities, identification of health risk factors, and interventions designed to reduce health risks, ameliorate health disparities, enhancing all aspects of health. The journal seeks to advance knowledge and theory in these domains in all segments of the population and across the lifespan, in local, national, and global contexts, and with an emphasis on the synergies that exist between biological, psychological, psychosocial, and structural factors as they related to these areas of study and across health states.
Behavioral Medicine publishes original empirical studies (experimental and observational research studies, quantitative and qualitative studies, evaluation studies) as well as clinical/case studies. The journal also publishes review articles, which provide systematic evaluations of the literature and propose alternative and innovative theoretical paradigms, as well as brief reports and responses to articles previously published in Behavioral Medicine.