DGS initiative chronic headache

25.08.2022 11:24

According to current estimates, more than 12 million people in Germany suffer from chronic headaches. The first point of contact is often general practitioners and specialists with family doctor functions. Now the German Society for Pain Medicine eV (DGS) has launched the “DGS Initiative for Chronic Headache – For Improvement in Primary Care”. The aim of the initiative is to give primary care specialist groups - the majority of whom have no special training in pain medicine - the opportunity to care for their patients based on the latest scientific findings.

At the same time, the initiative wants to help prevent the chronicity of headaches and substance misuse. “Our goal is to improve basic care for patients with chronic headaches,” says Dr. Johannes Horlemann, President of the DGS.

In Germany, 57.5 % of women and 44.4 % of men report being affected by headaches at least once within a year.1 14.8 % of women and 6 % of men meet the complete criteria for migraine.2 Estimates vary assumes that 12 million people in Germany suffer from chronic headaches. Migraines in particular occur more frequently in the middle years of life and affect patients in their most productive years and disrupt both professional and family life.3 “Many of those affected first turn to their family doctor, gynecologist or orthopedist with their headaches. They lack both training and experience to provide care. Headaches are the second most common reason for consultation in primary care,” complains PD Dr. Michael Küster, head of the Bonn / Bad Godesberg Pain Center, who, as Vice President of the DGS, is responsible for the headache department.

Lack of knowledge among doctors and patients

Professor Dr. Hartmut Göbel, chief physician at the Kiel Pain Clinic, which specializes in chronic neurological pain diseases, especially migraines and headaches, explains that the deficits are particularly evident in patients with migraines. Almost 40 % of those affected meet the criteria for prophylactic therapy, but only 12.4 % use it. According to the CaMEO (Chronic Migraine Epidemiology and Outcomes) study, fewer than 10 % of migraine patients achieve good medical results.5 “The reasons are varied,” says Göbel. The most important causes are a lack of knowledge among both doctors and patients. These led to inadequate attack therapy and prophylaxis. In addition, factors such as psychological comorbidities, headaches due to medication overuse and the lack of use of interdisciplinary therapies make the success of therapy more difficult. Important steps towards better care are the migraine special care contract and digital therapy support, e.g. B. via the migraine app.

Further training, practical guidelines and practical guidelines are intended to make care easier

The aim of the DGS chronic headache initiative is to improve care across the board. “Specialized care in a headache center is currently reserved for patients who present with particularly complicated courses and symptoms,” says Horlemann, who is overall responsible for the initiative. “The DGS initiative therefore wants to improve the basic care of patients with chronic headaches.” The aim is to improve the perception of headaches and to make access to modern therapy options easier across the board. In order to achieve these goals, the initiative offers doctors who provide primary care to patients new training opportunities. In addition, a revision of the DGS practice guidelines and, as the essence of this, a new DGS practice guidelines are to be created.

In order to collect current data on the real care of headache patients, the DGS is launching a new study in cooperation with the PraxisRegister Pain, parallel to and independent of the initiative.

Elements of the initiative include:
• Further development of the DGS practice guideline “Primary headache disorders”
• DGS practice guidelines “Primary headache disorders” – derived from the DGS practice guidelines
• DGS-CME continuing education projects in primary care
• Study in cooperation with the PraxisRegister Pain