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Raising the healthcare prioritization of headache: Why and how?
Headache is the most common neurologic disorder but the least acknowledged, said Professor Rigmor Jensen, Copenhagen, Denmark, in the Migraine Trust Lecture at the Migraine Trust International Symposium 2022. Strategies to raise the prioritization of healthcare provision for headache include increasing political awareness and education on the burden of headache and improving the organization of headache healthcare.
A common and expensive neurologic disease
Headache is a common neurologic brain disorder3
Headache is not another pain disorder. It is a neurologic brain disorder, said Professor Jensen. Among all diseases, it is the second leading cause of years of life lived with disability worldwide,1 Among neurologic diseases, it is the leading cause of years of life lived with disability worldwide.2
Headache is common, added Professor Jensen. It has a prevalence of 60% in Europe,3 and the prevalences of migraine, chronic headache, and medication overuse headache are 15%, 4%, and 1–2%, respectively.3
Among neurologic diseases, headache is the leading cause of years of life lived with disability worldwide2
As a result of the high prevalence and years of life lived with disability, headache is the third most expensive neurologic disorder in Europe after dementia and stroke. A total conservative estimate of annual cost in Europe in 2010 was €43.5 billion.4 Headache disorders are therefore prominent health-related drivers of economic losses.5
This huge economic cost has implications because it supports applications to improve healthcare provision, increase research funding, and to make headache a higher priority in university teaching, said Professor Jensen.
The third most expensive neurologic disorder in Europe after dementia and stroke4
Steps to raise the healthcare prioritization of headache
The correct diagnosis is the first step towards the right treatment and lowering the years of life lived with disability, said Professor Jensen.
Increasing political awareness can raise the profile of headache in the allocation of healthcare provision
Increasing political awareness and providing education for primary and specialist healthcare providers on the social and economic burdens of headache are also important to raise the profile of headache when allocating healthcare provision and funding.
In addition, improved organization of headache healthcare has been proposed by the Global Campaign against Headache,6 explained Professor Jensen:
- Level 1 — General primary care to manage 90% of the caseload and refer to Level 2 when necessary
- Level 2 — Special interest headache care to manage 9% of the caseload
- Level 3 — Headache specialist centers providing advanced multidisciplinary care by hospital-based headache specialists to manage 1% of the caseload
Structured services with provider-training and consumer education have been shown to be cost-effective for migraine7
Implementation of such structured services with provider-training and consumer education has been shown to be cost-effective for migraine and cost saving for tension-type headache and medication-overuse headache.7
Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.
References
- GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep 16;390(10100):1211–59.
- GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459–80.
- Stovner LJ, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain. 2010;11(4):289–99.
- Olesen J, Gustavsson A, Svensson M, et al. CDBE2010 study group; European Brain Council. The economic cost of brain disorders in Europe. Eur J Neurol. 2012;19(1):155–62.
- Linde M, Gustavsson A, Stovner LJ, et al. The cost of headache disorders in Europe: the Eurolight project. Eur J Neurol. 2012;19(5):703–11.
- Steiner TJ, Jensen R, Katsarava Z, et al; Lifting The Burden: the Global Campaign against Headache. Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description. J Headache Pain. 2021;22(1):78.
- Tinelli M, Leonardi M, Paemeleire K, et al; European Brain Council Value of Treatment Headache Working Group, the European Headache Federation, the European Migraine and Headache Alliance and Lifting the Burden: the Global Campaign against Headache. Structured headache services as the solution to the ill-health burden of headache. 3. Modelling effectiveness and cost-effectiveness of implementation in Europe: findings and conclusions. J Headache Pain. 2021;22(1):90.