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Structured Q1 Headache Services As the Solution to the Ill-Health Burden of Headache: 1. Rationale and Description Publisher Pubmed



Steiner TJ1, 2 ; Jensen R3 ; Katsarava Z4, 5, 6, 7 ; Stovner LJ1, 8 ; Uluduz D9 ; Adarmouch L10 ; Al Jumah M11 ; Al Khathaami AM12, 13 ; Ashina M3 ; Braschinsky M14 ; Broner S15 ; Eliasson JH16 ; Gilgouveia R17 ; Gomezgalvan JB18 Show All Authors
Authors
  1. Steiner TJ1, 2
  2. Jensen R3
  3. Katsarava Z4, 5, 6, 7
  4. Stovner LJ1, 8
  5. Uluduz D9
  6. Adarmouch L10
  7. Al Jumah M11
  8. Al Khathaami AM12, 13
  9. Ashina M3
  10. Braschinsky M14
  11. Broner S15
  12. Eliasson JH16
  13. Gilgouveia R17
  14. Gomezgalvan JB18
  15. Gudmundsson LS19
  16. Herekar AA20
  17. Kawatu N21
  18. Kissani N22, 23
  19. Kulkarni GB24
  20. Lebedeva ER25, 26
  21. Leonardi M27
  22. Linde M1, 8, 28
  23. Luvsannorov O29
  24. Maiga Y30
  25. Milanov I31
  26. Mitsikostas DD32
  27. Musayev T33
  28. Olesen J3
  29. Osipova V34, 35
  30. Paemeleire K36
  31. Peres MFP37
  32. Quispe G38
  33. Rao GN39
  34. Risal A40, 41
  35. De La Torre ER42
  36. Saylor D43, 44
  37. Togha M45, 46
  38. Yu SY47
  39. Zebenigus M48
  40. Zewde YZ48
  41. Zidverctrajkovic J49
  42. Tinelli M50
Show Affiliations
Authors Affiliations
  1. 1. Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
  2. 2. Division of Brain Sciences, Imperial College London, London, United Kingdom
  3. 3. Danish Headache Centre, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
  4. 4. Evangelical Hospital Unna, Unna, Germany
  5. 5. Department of Neurology, University of Duisburg-Essen, Essen, Germany
  6. 6. EVEX Medical Corporation, Tbilisi, Georgia
  7. 7. IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
  8. 8. Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway
  9. 9. Neurology Department, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
  10. 10. Community Medicine and Public Health Department, Cadi Ayyad University School of Medicine, Marrakech, Morocco
  11. 11. Department of Neurosciences, King Fahad Medical City, MOH, Riyadh, Saudi Arabia
  12. 12. King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  13. 13. King Abdulaziz Medical City, Riyadh, Saudi Arabia
  14. 14. Headache Clinic, Neurology Clinic, Tartu University Hospital, Tartu, Estonia
  15. 15. Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College, New York, NY, United States
  16. 16. Department of Neurology, Centralsjukhuset, Kristianstad, Sweden
  17. 17. Headache Centre, Neurology Department, Hospital da Luz, Lisbon, Portugal
  18. 18. Hospital de Sant Joan Despi Moises Broggi, Barcelona, Spain
  19. 19. Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
  20. 20. Department of Anesthesiology, Medical College of Georgia, Augusta University, Augusta, GA, United States
  21. 21. Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia
  22. 22. Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Universite Cadi Ayyad Marrakech, Marrakech, Morocco
  23. 23. Department of Neurology, University Teaching Hospital Mohammed VI, Marrakech, Morocco
  24. 24. Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
  25. 25. Department of Neurology and Neurosurgery, The Ural State Medical University, Yekaterinburg, Russian Federation
  26. 26. International Headache Centre “Europe-Asia�, Yekaterinburg, Russian Federation
  27. 27. Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
  28. 28. Tjorn Headache Clinic, Ronnang, Sweden
  29. 29. Department of Neurology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  30. 30. Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
  31. 31. Department of Neurology, University Hospital of Neurology and Psychiatry “St Naum�, Medical University Sofia, Sofia, Bulgaria
  32. 32. 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  33. 33. Chief of Department of Health Organization, Ministry of Health, Baku, Azerbaijan
  34. 34. Moscow Research Clinical Centre for Neuropsychiatry, Moscow, Russian Federation
  35. 35. University Headache Clinic, Moscow, Russian Federation
  36. 36. Department of Neurology, Ghent University Hospital, Ghent, Belgium
  37. 37. Institute of Psychiatry, University of Sao Paulo, Hospital Albert Einstein, Sao Paulo, Brazil
  38. 38. Department of Neurology, Hospital Luis Negreiros Vega, Callao, Lima, Peru
  39. 39. Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
  40. 40. Department of Psychiatry, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal
  41. 41. Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
  42. 42. European Migraine and Headache Alliance, Valencia, Spain
  43. 43. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  44. 44. Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
  45. 45. Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  46. 46. Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
  47. 47. International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, China
  48. 48. Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  49. 49. Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia
  50. 50. Care Policy and Evaluation Centre, The London School of Economics and Political Science, London, United Kingdom

Source: Journal of Headache and Pain Published:2021


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. © 2021, The Author(s).
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