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