Headache Patients’ Perspective on Access to Specialized Medical Care and Preventive Treatment in Portugal: A Cross-Sectional Study

Speaker(s)

Plácido M1, Santos B2, Chen-Xu J3, Paizinho R2, Laires P3, Gil-Gouveia R4
1Comprehensive Health Research Center, Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa; MiGRA Portugal – Portuguese Migraine and Headache Patients’ Association, Lisbon, Portugal, 2MiGRA Portugal – Portuguese Migraine and Headache Patients’ Association, Lisbon, Portugal, 3Comprehensive Health Research Center, Public Health Research Centre, National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal, 4Hospital da Luz Headache Center, Neurology Department, Hospital da Luz Lisboa; Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal

Presentation Documents

OBJECTIVES: To characterize headache healthcare access in Portugal from the patient’s perspective.

METHODS: A cross-sectional study in adult headache patients’ convenience sample, using an anonymous self-administered online questionnaire shared by MiGRA Portugal (Portuguese Headache and Migraine Patients Association). A descriptive analysis and Poisson regression models were used, adjusting for relevant variables and potential confounders.

RESULTS: There were 552 respondents with a mean age of 38 years, 96% were women and 74% had migraine. Medical follow-up for headache was lacking in 40% of participants.

Private institutions were used by 54% of patients with medical follow-up, mainly due to limited access to neurologist follow-up in public hospitals (56%). However, 26% of respondents followed in private institutions reported financial constraints to pay for their care and 20% paid out-of-pocket without any co-payment. Adjusting for relevant variables, opting for private appointments was the only statistically significant variable and it was associated with a 77% increased likelihood of being followed by a neurologist or headache specialist (prevalence ratio=1.77, confidence interval=1.26 to 2.50, p-value=0.01).

Preventive medication was not used by 54% of respondents and over 60% of respondents with preventive treatment were not satisfied, in 84% of the cases due to lack of effectiveness.

Even when considering only the patients with 15 or more days of headache attacks (chronic headache), 11% were not being followed by a physician regarding their headache and 31% did not use preventive medication.

CONCLUSIONS: These findings highlight considerable limitations in access to medical care and effective preventive treatment for headache in Portugal. In addition, in a country with a national health system that is intended to be universal, a considerable number of patients rely on private healthcare for headache management due to insufficient access to public services. An improvement of healthcare policies is urgent to ensure adequate headache management.

Code

HPR179

Topic

Health Policy & Regulatory

Topic Subcategory

Health Disparities & Equity, Insurance Systems & National Health Care

Disease

Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas