The Journal of Headache and Pain (Jul 2021)
Structured Q1 headache services as the solution to the ill-health burden of headache: 1. Rationale and description
- Timothy J. Steiner,
- Rigmor Jensen,
- Zaza Katsarava,
- Lars Jacob Stovner,
- Derya Uluduz,
- Latifa Adarmouch,
- Mohammed Al Jumah,
- Ali M. Al Khathaami,
- Messoud Ashina,
- Mark Braschinsky,
- Susan Broner,
- Jon H. Eliasson,
- Raquel Gil-Gouveia,
- Juan B. Gómez-Galván,
- Larus S. Gudmundsson,
- Akbar A. Herekar,
- Nfwama Kawatu,
- Najib Kissani,
- Girish Baburao Kulkarni,
- Elena R. Lebedeva,
- Matilde Leonardi,
- Mattias Linde,
- Otgonbayar Luvsannorov,
- Youssoufa Maiga,
- Ivan Milanov,
- Dimos D. Mitsikostas,
- Teymur Musayev,
- Jes Olesen,
- Vera Osipova,
- Koen Paemeleire,
- Mario F. P. Peres,
- Guiovanna Quispe,
- Girish N. Rao,
- Ajay Risal,
- Elena Ruiz de la Torre,
- Deanna Saylor,
- Mansoureh Togha,
- Sheng-Yuan Yu,
- Mehila Zebenigus,
- Yared Zenebe Zewde,
- Jasna Zidverc-Trajković,
- Michela Tinelli,
- on behalf of Lifting The Burden: the Global Campaign against Headache
Affiliations
- Timothy J. Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology
- Rigmor Jensen
- Danish Headache Centre, Department of Neurology, University of Copenhagen
- Zaza Katsarava
- Evangelical Hospital Unna
- Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology
- Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University
- Latifa Adarmouch
- Community Medicine and Public Health Department, Cadi Ayyad University School of Medicine
- Mohammed Al Jumah
- Department of Neurosciences, King Fahad Medical City, MOH
- Ali M. Al Khathaami
- King Saud Bin Abdulaziz University for Health Sciences
- Messoud Ashina
- Danish Headache Centre, Department of Neurology, University of Copenhagen
- Mark Braschinsky
- Headache Clinic, Neurology Clinic, Tartu University Hospital
- Susan Broner
- Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College
- Jon H. Eliasson
- Department of Neurology, Centralsjukhuset
- Raquel Gil-Gouveia
- Headache Centre, Neurology Department, Hospital da Luz
- Juan B. Gómez-Galván
- Hospital de Sant Joan Despí Moisès Broggi
- Larus S. Gudmundsson
- Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland
- Akbar A. Herekar
- Department of Anesthesiology, Medical College of Georgia, Augusta University
- Nfwama Kawatu
- Department of Paediatrics, University Teaching Hospital
- Najib Kissani
- Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Université Cadi Ayyad Marrakech
- Girish Baburao Kulkarni
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)
- Elena R. Lebedeva
- Department of Neurology and Neurosurgery, The Ural State Medical University
- Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
- Mattias Linde
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology
- Otgonbayar Luvsannorov
- Department of Neurology, Mongolian National University of Medical Sciences
- Youssoufa Maiga
- Faculty of Medicine, University of Technical Sciences and Technologies
- Ivan Milanov
- Department of Neurology, University Hospital of Neurology and Psychiatry “St Naum”, Medical University Sofia
- Dimos D. Mitsikostas
- 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens
- Teymur Musayev
- Chief of Department of Health Organization, Ministry of Health
- Jes Olesen
- Danish Headache Centre, Department of Neurology, University of Copenhagen
- Vera Osipova
- Moscow Research Clinical Centre for Neuropsychiatry
- Koen Paemeleire
- Department of Neurology, Ghent University Hospital
- Mario F. P. Peres
- Institute of Psychiatry, University of São Paulo, Hospital Albert Einstein
- Guiovanna Quispe
- Department of Neurology, Hospital Luis Negreiros Vega
- Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS)
- Ajay Risal
- Department of Psychiatry, Kathmandu University School of Medical Sciences (KUSMS)
- Elena Ruiz de la Torre
- European Migraine and Headache Alliance
- Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine
- Mansoureh Togha
- Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences
- Sheng-Yuan Yu
- International Headache Centre, Department of Neurology, Chinese PLA General Hospital
- Mehila Zebenigus
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University
- Yared Zenebe Zewde
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University
- Jasna Zidverc-Trajković
- Neurology Clinic, Clinical Centre of Serbia
- Michela Tinelli
- Care Policy and Evaluation Centre, The London School of Economics and Political Science
- on behalf of Lifting The Burden: the Global Campaign against Headache
- DOI
- https://doi.org/10.1186/s10194-021-01265-z
- Journal volume & issue
-
Vol. 22,
no. 1
pp. 1 – 22
Abstract
Abstract 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.
Keywords
- Headache disorders
- Public health
- Health policy
- Barriers to care
- Needs assessment
- Health-technology assessment
