Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description.
Journal: The journal of headache and pain
Volume: 22
Issue: 1
Year of Publication: 2021
Affiliated Institutions:
Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway. t.steiner@imperial.ac.uk.
Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark.
Evangelical Hospital Unna, Unna, Germany.
Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway.
Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey.
Community Medicine and Public Health Department, Cadi Ayyad University School of Medicine, Marrakech, Morocco.
Department of Neurosciences, King Fahad Medical City, MOH, Riyadh, Saudi Arabia.
King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Headache Clinic, Neurology Clinic, Tartu University Hospital, Tartu, Estonia.
Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College, New York, NY, USA.
Department of Neurology, Centralsjukhuset, Kristianstad, Sweden.
Headache Centre, Neurology Department, Hospital da Luz, Lisbon, Portugal.
Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain.
Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Department of Anesthesiology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia.
Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Université Cadi Ayyad Marrakech, Marrakech, Morocco.
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Department of Neurology and Neurosurgery, The Ural State Medical University, Yekaterinburg, Russia.
Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Department of Neurology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali.
Department of Neurology, University Hospital of Neurology and Psychiatry "St Naum", Medical University Sofia, Sofia, Bulgaria.
st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Chief of Department of Health Organization, Ministry of Health, Baku, Azerbaijan.
Moscow Research Clinical Centre for Neuropsychiatry, Moscow, Russian Federation.
Department of Neurology, Ghent University Hospital, Ghent, Belgium.
Institute of Psychiatry, University of São Paulo, Hospital Albert Einstein, São Paulo, Brazil.
Department of Neurology, Hospital Luis Negreiros Vega, Callao, Lima, Peru.
Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Department of Psychiatry, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
European Migraine and Headache Alliance, Valencia, Spain.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, China.
Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.
Care Policy and Evaluation Centre, The London School of Economics and Political Science, London, UK.
Abstract summary
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.
Authors & Co-authors:
Steiner Timothy J TJ
Jensen Rigmor R
Katsarava Zaza Z
Stovner Lars Jacob LJ
Uluduz Derya D
Adarmouch Latifa L
Al Jumah Mohammed M
Al Khathaami Ali M AM
Ashina Messoud M
Braschinsky Mark M
Broner Susan S
Eliasson Jon H JH
Gil-Gouveia Raquel R
Gómez-Galván Juan B JB
Gudmundsson Larus S LS
Herekar Akbar A AA
Kawatu Nfwama N
Kissani Najib N
Kulkarni Girish Baburao GB
Lebedeva Elena R ER
Leonardi Matilde M
Linde Mattias M
Luvsannorov Otgonbayar O
Maiga Youssoufa Y
Milanov Ivan I
Mitsikostas Dimos D DD
Musayev Teymur T
Olesen Jes J
Osipova Vera V
Paemeleire Koen K
Peres Mario F P MFP
Quispe Guiovanna G
Rao Girish N GN
Risal Ajay A
de la Torre Elena Ruiz ER
Saylor Deanna D
Togha Mansoureh M
Yu Sheng-Yuan SY
Zebenigus Mehila M
Zewde Yared Zenebe YZ
Zidverc-Trajković Jasna J
Tinelli Michela M
Study Outcome
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