TY - JOUR

T1 - Structured Q1 headache services as the solution to the ill-health burden of headache

T2 - 1. Rationale and description

AU - Steiner, Timothy J.

AU - Jensen, Rigmor

AU - Katsarava, Zaza

AU - Stovner, Lars Jacob

AU - Uluduz, Derya

AU - Adarmouch, Latifa

AU - Al Jumah, Mohammed

AU - Al Khathaami, Ali M.

AU - Ashina, Messoud

AU - Braschinsky, Mark

AU - Broner, Susan

AU - Eliasson, Jon H.

AU - Gil-Gouveia, Raquel

AU - Gómez-Galván, Juan B.

AU - Gudmundsson, Larus S.

AU - Herekar, Akbar A.

AU - Kawatu, Nfwama

AU - Kissani, Najib

AU - Kulkarni, Girish Baburao

AU - Lebedeva, Elena R.

AU - Leonardi, Matilde

AU - Linde, Mattias

AU - Luvsannorov, Otgonbayar

AU - Maiga, Youssoufa

AU - Milanov, Ivan

AU - Mitsikostas, Dimos D.

AU - Musayev, Teymur

AU - Olesen, Jes

AU - Osipova, Vera

AU - Paemeleire, Koen

AU - Peres, Mario F.P.

AU - Quispe, Guiovanna

AU - Rao, Girish N.

AU - Risal, Ajay

AU - de la Torre, Elena Ruiz

AU - Saylor, Deanna

AU - Togha, Mansoureh

AU - Yu, Sheng Yuan

AU - Zebenigus, Mehila

AU - Zewde, Yared Zenebe

AU - Zidverc-Trajković, Jasna

AU - Tinelli, Michela

AU - on behalf of Lifting The Burden: the Global Campaign against Headache

N1 - Publisher Copyright: © 2021, The Author(s).

PY - 2021

Y1 - 2021

N2 - In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

AB - In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

KW - Barriers to care

KW - Global Campaign against headache

KW - Headache disorders

KW - Health policy

KW - Health-technology assessment

KW - Needs assessment

KW - Primary care

KW - Public health

KW - Service organization and delivery

KW - Structured headache services

U2 - 10.1186/s10194-021-01265-z

DO - 10.1186/s10194-021-01265-z

M3 - Journal article

C2 - 34289806

AN - SCOPUS:85109070300

VL - 22

JO - Journal of Headache and Pain

JF - Journal of Headache and Pain

SN - 1129-2369

M1 - 78

ER -