• Britta Müller, Thomas Dresler, Charly Gaul, Tim Jürgens, Peter Kropp, Anna Rehfeld, Olaf Reis, Ruth Ruscheweyh, Andreas Straube, and Stefanie Förderreuther.
• Institute of Medical Psychology and Medical Sociology, University Medicine Rostock, Gehlsheimer Str. 20, D-18147, Rostock, Germany. britta.mueller@med.uni-rostock.de.
• J Headache Pain. 2020 May 11; 21 (1): 49.

BackgroundHeadache sufferers in need of professional health care often do not utilize the care available, and factors influencing headache-specific physician consultation are not yet understood. Objectives of this study are (1) to assess self-reported headache-specific physician consultations and (2) to identify headache-related and sociodemographic predictors.MethodsData of a random sample of the general population in Germany aged ≥14 years were analyzed (N = 2461). A multivariate binary logistic regression was conducted to identify a parsimonious model to predict physician consultation.Results50.7% of the participants with headache reported at least one headache-specific physician consultation during lifetime. Of these, 53.6% had seen one, 26.1% two, and 20.3% more than two physicians because of their headaches. The odds of physician consultation increased with the number of headache days per month (HDM) [(reference HDM < 1) HDM 1-3 (OR = 2.29), HDM 4-14 (OR = 2.41), and HDM ≥15 (OR = 4.83)] and increasing Headache Impact Test score (HIT-6) [(reference "no or little impact") moderate impact (OR = 1.74), substantial impact (OR = 3.01), and severe impact (OR = 5.08)]. Middle-aged participants were more likely to have consulted than younger and older ones [(reference 14-34 years) 35-54 years (OR = 1.90), 55-74 years (OR = 1.96), ≥75 years (OR = 1.02)]. The odds of physician consultation among self-employed subjects were lower than among employed manual workers (OR = 0.48). The living environment (rural versus urban) did not have an influence on the consultation frequency.ConclusionThe results indicate that apart from burden-related factors (headache frequency; headache impact), health care utilization patterns are also influenced by patients' occupational status and age. Further research is needed to analyze whether the lower consultation rate means that the self-employed have a higher risk of chronification or that they have more effective self-management strategies regarding headache.

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