@article{3033297,
    title = "Structured Q1 headache services as the solution to the ill-health burden
of headache: 1. Rationale and description",
    author = "Steiner, Timothy J. and Jensen, Rigmor and Katsarava, Zaza and Stovner, and Lars Jacob and Uluduz, Derya and Adarmouch, Latifa and Al Jumah, and Mohammed and Al Khathaami, Ali M. and Ashina, Messoud and Braschinsky, and Mark and Broner, Susan and Eliasson, Jon H. and Gil-Gouveia, Raquel and and Gomez-Galvan, Juan B. and Gudmundsson, Larus S. and Herekar, Akbar A. and and Kawatu, Nfwama and Kissani, Najib and Kulkarni, Girish Baburao and and Lebedeva, Elena R. and Leonardi, Matilde and Linde, Mattias and and Luvsannorov, Otgonbayar and Maiga, Youssoufa and Milanov, Ivan and and Mitsikostas, Dimos D. and Musayev, Teymur and Olesen, Jes and Osipova, and Vera and Paemeleire, Koen and Peres, Mario F. P. and Quispe, Guiovanna and and Rao, Girish N. and Risal, Ajay and de la Torre, Elena Ruiz and and Saylor, Deanna and Togha, Mansoureh and Yu, Sheng-Yuan and Zebenigus, and Mehila and Zewde, Yared Zenebe and Zidverc-Trajkovic, Jasna and Tinelli, and Michela and Global Campaign Against Headache",
    journal = "The Journal of Headache and Pain",
    year = "2021",
    volume = "22",
    number = "1",
    publisher = "BMC",
    issn = "1129-2369, 1129-2377",
    doi = "10.1186/s10194-021-01265-z",
    keywords = "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",
    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."
}