Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description

The Journal of Headache and Pain

Dimos D. Mitsikostas¹  Michela Tinelli²  Teymur Musayev³  Latifa Adarmouch⁴  Rigmor Jensen⁵  Messoud Ashina⁵  Jes Olesen⁵  Akbar A. Herekar⁶  Girish N. Rao⁷  Elena R. Lebedeva⁸  Jon H. Eliasson⁹  Koen Paemeleire^1,10  Guiovanna Quispe^1,11  Deanna Saylor^1,12  Otgonbayar Luvsannorov^1,13  Girish Baburao Kulkarni^1,14  Yared Zenebe Zewde^1,15  Mehila Zebenigus^1,15  Ivan Milanov^1,16  Timothy J. Steiner^1,17  Lars Jacob Stovner^1,18  Mattias Linde^1,19  Mohammed Al Jumah^2,20  Nfwama Kawatu^2,21  Ajay Risal^2,22  Elena Ruiz de la Torre^2,23  Zaza Katsarava^2,24  Youssoufa Maiga^2,25  Larus S. Gudmundsson^2,26  Raquel Gil-Gouveia^2,27  Mark Braschinsky^2,28  Juan B. Gómez-Galván^2,29  Mario F. P. Peres^3,30  Sheng-Yuan Yu^3,31  Ali M. Al Khathaami^3,32  Najib Kissani^3,33  Vera Osipova^3,34  Jasna Zidverc-Trajković^3,35  Derya Uluduz^3,36  Mansoureh Togha^3,37  Matilde Leonardi^3,38  Susan Broner^3,39 

[1] 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;Care Policy and Evaluation Centre, The London School of Economics and Political Science, London, UK;Chief of Department of Health Organization, Ministry of Health, Baku, Azerbaijan;Community Medicine and Public Health Department, Cadi Ayyad University School of Medicine, Marrakech, Morocco;Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark;Department of Anesthesiology, Medical College of Georgia, Augusta University, Augusta, GA, USA;Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India;Department of Neurology and Neurosurgery, The Ural State Medical University, Yekaterinburg, Russia;International Headache Centre “Europe-Asia”, Yekaterinburg, Russia;Department of Neurology, Centralsjukhuset, Kristianstad, Sweden;Department of Neurology, Ghent University Hospital, Ghent, Belgium;Department of Neurology, Hospital Luis Negreiros Vega, Callao, Lima, Peru;Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia;Department of Neurology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia;Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India;Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Neurology, University Hospital of Neurology and Psychiatry “St Naum”, Medical University Sofia, Sofia, Bulgaria;Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway;Division of Brain Sciences, Imperial College London, London, UK;Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway;Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway;Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway;Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway;Tjörn Headache Clinic, Rönnäng, Sweden;Department of Neurosciences, King Fahad Medical City, MOH, Riyadh, Saudi Arabia;Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia;Department of Psychiatry, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal;Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal;European Migraine and Headache Alliance, Valencia, Spain;Evangelical Hospital Unna, Unna, Germany;Department of Neurology, University of Duisburg-Essen, Essen, Germany;EVEX Medical Corporation, Tbilisi, Georgia;IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation;Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali;Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland;Headache Centre, Neurology Department, Hospital da Luz, Lisbon, Portugal;Headache Clinic, Neurology Clinic, Tartu University Hospital, Tartu, Estonia;Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain;Institute of Psychiatry, University of São Paulo, Hospital Albert Einstein, São Paulo, Brazil;International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, China;King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;King Abdulaziz Medical City, Riyadh, Saudi Arabia;Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Université Cadi Ayyad Marrakech, Marrakech, Morocco;Department of Neurology, University Teaching Hospital Mohammed VI, Marrakech, Morocco;Moscow Research Clinical Centre for Neuropsychiatry, Moscow, Russian Federation;University Headache Clinic, Moscow, Russian Federation;Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia;Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey;Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran;Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy;Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College, New York, NY, USA;

关键词: Headache disorders;    Public health;    Health policy;    Barriers to care;    Needs assessment;    Health-technology assessment;    Structured headache services;    Service organization and delivery;    Primary care;    Global Campaign against Headache;   

DOI  :  10.1186/s10194-021-01265-z

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY