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Migraine: epidemiology and systems of care

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LANCET
卷 397, 期 10283, 页码 1485-1495

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ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(20)32160-7

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Migraine is a global neurovascular disorder that has negative impacts on patients, families, and society. Integrated and coordinated care systems can help reduce this burden. Low and middle-income countries face challenges in migraine care due to inadequate public health education and access to medication.
Migraine is a neurovascular disorder that affects over 1 billion people worldwide. Its widespread prevalence, and associated disability, have a range of negative and substantial effects not only on those immediately affected but also on their families, colleagues, employers, and society. To reduce this global burden, concerted efforts are needed to implement and improve migraine care that is supported by informed health-care policies. In this Series paper, we summarise the data on migraine epidemiology, including estimates of its very considerable burden on the global economy. First, we present the challenges that continue to obstruct provision of adequate care worldwide. Second, we outline the advantages of integrated and coordinated systems of care, in which primary and specialist care complement and support each other; the use of comprehensive referral and linkage protocols should enable continuity of care between these systems levels. Finally, we describe challenges in low and middle-income countries, including countries with poor public health education, inadequate access to medication, and insufficient formal education and training of health-care professionals resulting in misdiagnosis, mismanagement, and wastage of resources.

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