Headache Centre Coordinator takes Portugal’s Experience to the European Parliament

Centro de Cefaleias Parlamento Europeu

Raquel Gil-Gouveia, neurologist and coordinator of Hospital da Luz Lisboa Headache Centre, was one of the invited speakers in a conference on this disease, held at the European Parliament on January 24.

“Making visible the invisible on headache pain” was the session’s theme, organized by the Portuguese Eurodeputy Sofia Ribeiro, in the sequence of requests from patient associations that have been alerting to the need of making headache a priority, in terms of health public policies.

Migraine and headache affect about 13% of the world population and are classified by the World Health Organization as a main cause of neurologic incapacity. Despite causing high absenteeism, mostly from work and school, with great financial costs, this is a disease that tends to be undermined by society and is underdiagnosed. “Most countries don’t even include headache in their health reports”, highlighted Raquel Gil-Gouveia (the third on the left, in the image above).

Member of the Portuguese Headache Society Scientific Board, the neurologist from Hospital da Luz participated in the discussion panel dedicated to successful experiences in healthcare provided in this area, in several European countries.

Maria Teresa Flor de Lima (anaesthesiologist and founder of the Chronic Pain Patients Association in the Azores), Elena Ruiz Barreda (president of the European Headache Alliance), Koen Paemeleire (European Headache Federation) and Cristina Tassorelli (professor of neurology in Pavia University, Italy) were other invited speakers.

Experience in public and private sector

Focusing on Portuguese reality – where a million patients are estimated –, Raquel Gil-Gouveia stated that the country has a good ratio of neurologists (4.5 per 100 thousand inhabitants), but the National Health Service has yet no strategy for the area.

And like in other European countries, “the lack of training in the specific approach to headache is the main problem identified by neurologists”, although the Portuguese Headache Society has been trying to overcome that lack through the regular organization of courses, congresses and research scholarships.

Nevertheless, 17 hospitals, in large population centres, offer headache consultations – research activity being also developed in those units connected to universities, such as Coimbra, Porto and Lisboa (the headache consultation at Hospital de Santa Maria presently celebrating 40 years).

Other positive aspect is that there are no restrictions to the prescription of medicine, mostly reimbursed.

Raquel Gil-Gouveia referred, then, Hospital da Luz Lisboa’s experience, with the creation in 2012 of the Headache Centre: “the positive aspect is that it makes it easier to implement the most adequate approach to the problem of headache, namely through a multidisciplinary team including, right from the start, family doctors, physiotherapists, psychiatrists, gynaecologists, dentists and nurses, allowing healthcare articulation”.

Since late 2016, patients with headache have also access to Hospital da Luz Digital Clinical Centre (dedicated to surveillance and follow-up of chronic disease); via teleconsultation and the possibility of digital registry of headache crises and other associated data, patients benefit from a closest follow-up by their neurologist.