Analysis of headache management in Andalusia

M Millán Vázquez; R Lamas Pérez; F J Viguera Romero; C Jurado Cobo; M Jiménez Parra; A Gómez Camello; M D Jiménez Hernández; F León; J F Frías Rodríguez; C González Oria

doi:10.1016/j.nrleng.2023.04.007

Analysis of headache management in Andalusia

Neurologia (Engl Ed). 2023 Apr 28:S2173-5808(23)00032-9. doi: 10.1016/j.nrleng.2023.04.007. Online ahead of print.

Affiliations

¹ Hospital Universitario Virgen del Rocío, Sevilla, Spain. Electronic address: manuel.millan@sspa.juntadeandalucia.es.
² Hospital Universitario Virgen del Rocío, Sevilla, Spain.
³ Hospital Universitario Virgen Macarena, Sevilla, Spain.
⁴ Hospital Universitario Reina Sofía, Córdoba, Spain.
⁵ Hospital Universitario Virgen de la Victoria, Málaga, Spain.
⁶ Hospital Universitario Clínico San Cecilio, Granada, Spain.
⁷ Centro de Salud Zaidín Sur, Granada, Spain.
⁸ Hospital Universitario Virgen de las Nieves, Granada, Spain.

PMID: 37120110
DOI: 10.1016/j.nrleng.2023.04.007

Abstract

Introduction and objective: Headache is a frequent reason for consultation between primary care physicians, emergency services physicians, and neurology specialists; however, it is not always well managed. The Andalusian Society of Neurology's Headache Study Group (SANCE) aimed to analyse headache management at different levels of care.

Material and methods: We conducted a descriptive cross-sectional study with data gathered through a retrospective survey in July 2019. Participants completed a series of structured questionnaires on different social and work-related variables from 4 different groups of healthcare professionals (primary care [PC], emergency departments, neurology departments, headache units).

Results: A total of 204 healthcare professionals completed the survey: 35 emergency department physicians, 113 PC physicians, 37 general neurologists, and 19 neurologists specialising in headache. Eighty-five percent of PC physicians reported prescribing preventive drugs, which were maintained for at least 6 months (59%), with flunarizine and amitriptyline being the most commonly used. Most patients attended at neurology consultations (65%) are referred by PC physicians, with changes in the headache pattern being the main reason for referral (74%). Healthcare professionals across all levels of care showed great interest in headache and in receiving training in headache management (97% of PC physicians, 100% of emergency services physicians, 100% of general neurologists).

Conclusions: Migraine sparks great interest among healthcare professionals from different levels of care. Our results also reveal a lack of resources for headache management, which is reflected in the long waiting times. Other means of bilateral communication between different levels of care should be explored (eg, e-mail).

Keywords: Atención primaria; Cefalea; Formación profesionales; Headache; Levels of care; Manejo terapéutico; Migraine; Migraña; Niveles asistenciales; Primary care; Therapeutic management; Training.