Headache care and service in Latvia. Challenges, priorities and further perspectives

Headache disorders are prevalent and disabling. They are still under-recognized, under-diagnosed and under-treated, despite largely treatable. Health care for headache must be improved through well-organized health services and supported by education at multiple levels.  The main aims of this study were to assess the current situation on headache care in Latvia and to identify the urgent needs in headache care in Latvia An electronic questionnaire survey of the three main groups involved in headache care -neurologists, general practitioners and patients. The questionnaire covered 7 themes related to headache care: epidemiology, diagnosis and assessment, treatment, human resources, headache impact, and issues.  A total of 150 respondents were interviewed (50 patients, 50 family doctors, 50 neurologists). The most unsatisfied of headache care were patients, rating of 4,5 (from 1-10) and the main obstacle stressing an inadequate availability of appropriate medication due to the financial barrier. A general practitioners major challenge is a poor availability to a headache -specific health care. In turn, neurologists highlight lack of physicians knowledge of headache disorders. There are silent findings in this study that demonstrate unmet needs mentioned above. The most notable to point out is inappropriate headache treatment reported by physicians and the insufficient control over headaches noted by patients. Latvia faces a similar challenge in headache care like elsewhere in the world. The substantial call for action is better education both for professionals and patients. Improvement of availability to appropriate medications is an unmet need to reduce the burden of headaches in Latvia.