OBJECTIVES: Headache patients are frequently diagnosed with multiple additional ‘functional’ or ‘medically unexplained’ symptoms (Errico, 2014). As a result these patients suffer with poor quality of life and consume high levels of healthcare resource. Non-invasive vagus nerve stimulation (nVNS), delivered via a therapeutic medical device, is proven to be efficacious in the treatment of primary headache disorders (Gaul, 2016). Here we report the impact of prescribing the device in a real-world primary care setting, for patients suffering with headache and multi-morbidity. METHODS: Multi-morbid patients were identified from 7 general practice sites and provided with a 15-minute consultation with nVNS device training. Patients were advised to use the device bilaterally, 3 times a day, as an adjunct to their existing medication. Prior to the start of therapy, and then every subsequent 4 weeks, patients provided health related quality of life EQ-5D-5L assessments. Healthcare resource utilisation was collected from primary care electronic medical records and measured pre- and post-study, time-matched to the duration the individual patient stayed on therapy. RESULTS: At baseline the mean EQ-5D-5L utility and VAS score were 0.58 and 58.1 respectively (n=233). Improvements in EQ-5D-5L and VAS were observed within 8-12 weeks of nVNS therapy, and after 52 weeks the mean EQ-5D-5L utility and VAS score increased to 0.68 and 71.7 respectively. The change in EQ-5D-5L index score (0.1) was above the reported minimally important difference (MID; 0.074, Walters, 2005) and was considered clinically meaningful. The amount of GP consultations and subsequent referals into secondary care that these patients required decreased by 20% and 23% respectively (n=233, on therapy for a mean duration of 231 days), delivering considerable healthcare resource savings. CONCLUSIONS: The results of this real-world evaluation demonstrate that; the implementation of nVNS therapy in primary care, improves quality of life and reduces healthcare resource in multi-morbid patients.