A pain management network with pain specialists and general practitioners was established in Cologne to examine and improve the structures of outpatient headache management. The project was divided into an analysis of pain management (P1; one year) and a second phase (P2; two years) with interventions like consultations and education. Eighty physicians working in general practice participated. Patients' and physicians' data on pain and treatment were documented three times (T1, T2, T3) within 12 weeks. Differences in pain relief and quality of life were compared between P1 and P2. Most of the outcome parameters were improved in T2. These changes were more evident in P2. In P2, physicians increasingly used headache diaries and recommended psychotherapy. Triptans were prescribed more frequently for migraine and antidepressants for tension-type headache. The network provided an improvement in outpatient health care of headache patients.