Situación de partida y abordaje asistencial de la migraña en las consultas de neurología de España. Estudio PRIMERA

Mateos,; Porta‐Etessam, J.; Armengol-Bertolin, S; Larios, Carlos Moradillo; García, M; Er, En Representacion de Los Investigadores Del Estudio Primera

doi:10.33588/rn.5510.2012295

Cited by 2 publications

(1 citation statement)

References 22 publications

(22 reference statements)

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“…For example, in Spain less than 20% of migraine patients receive the prescription of a triptan (of choice in the symptomatic treatment of moderate-intense crises), ergotics and opioids are still prescribed to a significant number of patients although we know that they induce headache chronicity and there is an underuse of preventive treatment. 20 As for diagnostic barriers, and probably due to an excessively sharp interpretation of the diagnostic criteria of the different primary headaches, the classification of the different headaches remains a problem for primary headaches, which is undoubtedly one of the causes that justify the excess of diagnostic tests, also identified as a barrier. 21 22 The results of this study, which identify the main barriers in the care pathway for headache patients, could help to introduce the necessary organisational modifications to achieve optimal quality of care following the standards that the European scientific literature has indicated as appropriate.…”

Section: Discussionmentioning

confidence: 99%

Proposal of a clinical care pathway for quality and safe management of headache patients: a consensus study report

et al. 2020

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BackgroundHeadache is one of the most prevalent and disabling conditions. Its optimal management requires a coordinated and comprehensive response by health systems, but there is still a wide variability that compromises the quality and safety of the care process.PurposeTo establish the basis for designing a care pathway for headache patients through identifying key subpathways in the care process and setting out quality and clinical safety standards that contribute to providing comprehensive, adequate and safe healthcare.MethodA qualitative research study based on the consensus conference technique. Eleven professionals from the Spanish National Health System participated, seven of them with clinical experience in headache and four specialists in healthcare management and quality. First, identification of the key subpathways in the care process for headache, barriers/limitations for optimal quality of care, and quality and safety standards applied in each subpathway. Second, two consecutive consensus rounds were carried out to assess the content of the subpathway level descriptors, until the expert agreement was reached. Third, findings were assessed by 17 external healthcare professionals to determine their understanding, adequacy and usefulness.ResultsSeven key subpathways were identified: (1) primary care, (2) emergency department, (3) neurology department, (4) specialised headache unit, (5) hospitalisation, (6) outpatients and (7) governance and management. Sixty-seventh barriers were identified, the most frequent being related to diagnostic errors (36,1%), resource deficiency (25%), treatment errors (19,4%), lack of health literacy (13,9%) and inadequate communications with care transitions (5,6%). Fifty-nine quality and 31 safety standards were defined. They were related to evaluation (23.3%), patient safety (21.1%), comprehensive care (12.2%), treatment (12.2%), clinical practice guidelines (7.8%), counselling (6.7%), training (4.4%) and patient satisfaction (3.3%).ConclusionsThis proposal incorporates a set of indicators and standards, which can be used to define a pathway for headache patients and determine the levels of quality.

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Section: Discussionmentioning

confidence: 99%

Proposal of a clinical care pathway for quality and safe management of headache patients: a consensus study report

et al. 2020

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Analysis of the management and costs of headache disorders in Spain during the period 2011–2016: a retrospective multicentre observational study

Darbà

Marsà²

2020

BMJ Open

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ObjectivesTo investigate the number and characteristics of the Spanish population affected by headache disorders and the direct medical cost that these patients represent for the healthcare system.DesignA retrospective multicentre observational study.SettingRecords from all patients admitted with headache in primary and secondary care centres in Spain between 2011 and 2016 that were registered in a Spanish claims database were included in the analysis. Direct medical costs were calculated using the standardised average expenses of medical procedures determined by the Spanish Ministry of Health.ResultsData extraction claimed primary care records from 636 722 patients and secondary care records from 30 077 patients. Women represented 63% and 65% of all patients with headache in primary and secondary care respectively, with the exception of cluster headaches, a group with 60% of male patients. No large shifts were observed over time in patients’ profile; contrarily, the number of cases per 10 000 patients attended in primary care increased 2-folds between 2011 and 2016 for migraine and 1.85-folds for other headaches. Migraine was the cause for 28% of primary care consultations and 50% of secondary care admissions, and it was responsible for the largest portion of healthcare costs in 2016, a total amount of € 7 302 718. The estimated annual direct medical cost of headache disorders was € 10 716 086.ConclusionsMigraine was responsible for half of the secondary care admissions linked to headache disorders. The raise detected in the number of cases registered in primary care is likely to impact the direct medical costs associated to these disorders causing an increase in the total burden they represent for the Spanish National Healthcare System.

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Situación de partida y abordaje asistencial de la migraña en las consultas de neurología de España. Estudio PRIMERA

Cited by 2 publications

References 22 publications

Proposal of a clinical care pathway for quality and safe management of headache patients: a consensus study report

Proposal of a clinical care pathway for quality and safe management of headache patients: a consensus study report

Analysis of the management and costs of headache disorders in Spain during the period 2011–2016: a retrospective multicentre observational study

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