- Leone Ridsdale: Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London. L.Ridsdale@iop.kcl.ac.uk
BACKGROUND: There is poor access to neurology services for patients in the community.
AIM: To describe the training of GPs with special interest (GPwSI) in headache and the setting up of a GPwSI clinic in general practice, and report on a comparison with the existing neurology service in terms of case severity, patient satisfaction, and cost.
DESIGN OF STUDY: New service provision and evaluation by a questionnaire survey.
SETTING: General practice and hospital neurology service in inner-city London.
METHOD: The intervention involved training GPs as GPwSIs and setting up a GP headache service. A questionnaire survey was conducted, measuring headache impact, satisfaction, and cost estimates.
RESULTS: Headache impact was not significantly different between the two groups of patients, referred to hospital and to a GPwSI. Patients were significantly more satisfied with the GPwSI service, particularly that the service was effective in helping to relieve their symptoms (89% versus 76%; adjusted odds ratio=7.7; 95% confidence interval=2.7 to 22.4). The cost per first appointment was estimated to be pound sterling 136, with pound sterling 68 for subsequent contacts. These are lower than costs for neurologist contacts.
CONCLUSION: GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.