The Yekaterinburg headache initiative: an interventional project, within the Global Campaign against Headache, to reduce the burden of headache in Russia.

Elena R Lebedeva,Larisa I Volkova,Vera V Osipova,Jes Olesen,Timothy J Steiner,Guzyal R Tabeeva

doi:10.1186/1129-2377-14-101

Abstract

BackgroundAs major causes of global public ill-health and disability, headache disorders are paradoxically ignored in health policy and in planning, resourcing and implementing health services. This is true worldwide. Russia, where the prevalence of headache disorders and levels of attributed disability are well in excess of the global and European averages, is no exception, while arcane diagnoses and treatment preferences are an aggravating factor. Urgent remedial action, with political support, is called for.MethodsYekaterinburg, in Sverdlovsk Oblast, is the chosen centre for a demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation) for efficient and equitable delivery of headache-related health care; 3) develop a range of educational initiatives aimed at primary-care physicians, non-specialist neurologists, pharmacists and the general public to support the second action.Results and conclusionWe set these proposals in a context of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache initiative can achieve, the more likely it is that this support will be forthcoming.

Highlights

As major causes of global public ill-health and disability, headache disorders are paradoxically ignored in health policy and in planning, resourcing and implementing health services
The consequential societal costs in productivity losses are very high [4]: in Russia, they account for 1.75% of gross domestic product (GDP) [11], which is over one third of all expenditure on health care [20];
About 90% of headache patients are managed in primary care; about 1% require specialist care; the intermediate 9-10%, whilst not requiring this, present diagnostic or management difficulties that call for a higher level of expertise than can be expected of the average Primary-care physician (PCP)

Summary

Introduction

As major causes of global public ill-health and disability, headache disorders are paradoxically ignored in health policy and in planning, resourcing and implementing health services. In Western Europe, where the burden of headache is best measured [1,2], the lives of about 17% of adults are affected by headache disorders to the extent that they would benefit from professional medical care [3]. Most of these people (about 14%) have migraine; some have frequent episodic tension-type headache (TTH). In the European Union, the annual financial cost of headache, due mostly to lost productivity, has been estimated in one study at €44 billion [7] and in another at more than €100 billion [4]

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