Prevalence, medication use, and health care utilization in pediatric primary headache: a school-based cross-sectional study
Februar, 2026
Zusammenfassung
Background Primary headache disorders are the most common neurological conditions affecting children and
adolescents and among the leading causes of disability worldwide. However, population-level data on prevalence,
medication use, and health care utilization remain limited. This study assessed the prevalence of recurrent primary
headache, migraine, and tension type headache, and examined associated patterns of medication use and health
care utilization.
Methods A cross-sectional survey was conducted among students in grades 6–12 across 11 schools in Central
Florida, USA. Self-administered questionnaires captured headache characteristics and relevant clinical, psychological,
and behavioral factors. Migraine and tension type headache were classified according to self-reported International
Classification of Headache Disorders, 3rd Edition diagnostic criteria. Descriptive statistics and regression models
examined demographic associations with headache type and prediction models of medication use and health care
utilization.
Results The sample included N = 583 students (Mage=13.58, SD = 2.25), of whom 53% were female. Overall, 67%
reported experiencing at least one headache in the past three months. In the total sample, 30% of students reported
at least weekly recurrent primary headache, 18.2% fulfilled criteria for migraine and 24.9% for tension type headache.
Female students had higher odds of experiencing recurrent primary headache than male students (OR = 2.80, 95%
CI [1.90, 4.12]), while age was not a significant predictor. Among students experiencing recurrent primary headache,
73.7% reported using medication, and 24.6% had sought medical attention for headaches in the past three months.
Over-the-counter medication use was predicted by higher headache frequency, passive pain coping, and social
support seeking. Prescription medication use was predicted by sex, language, headache intensity and frequency,
stress and passive pain coping strategies. No demographic, psychological or clinical variables significantly predicted
headache-related health care utilization in this sample.
Conclusions Primary headaches and associated medication use are highly prevalent in youth. These findings
highlight the need for improved monitoring and targeted intervention strategies to reduce the prevalence and
burden of pediatric primary headache disorders. Increased attention to medication patterns and health care
utilization may inform and facilitate action in health policy responses.
