Migraine as a primary care-sensitive condition: Building pathways to accessible care.

Area of Science:

• Neurology and Public Health: Focuses on classifying migraine as a Primary Care-Sensitive Condition (PCSC) and its implications for healthcare systems globally.

Background:

• Migraine is a leading cause of global disability, often leading to emergency visits and lost productivity.
• Current PCSC classifications often underrecognize migraine, despite its significant impact.
• This review assesses migraine's eligibility for PCSC status and its potential benefits, especially in low- and middle-income countries.

Purpose of the Study:

• To evaluate if migraine meets the criteria for classification as a Primary Care-Sensitive Condition (PCSC).
• To discuss the public health, clinical, and economic implications of designating migraine as a PCSC.
• To explore how this designation can enhance access to care across diverse healthcare systems.

Main Methods:

• A narrative review was conducted, analyzing migraine against five established PCSC criteria.
• Criteria included evidence for primary care management, public health relevance, diagnostic clarity, potential to avoid hospitalization, and severe case hospitalization possibility.
• Global data on migraine epidemiology, diagnosis, treatment, and health system impact were synthesized.

Main Results:

• Migraine satisfies all five criteria for PCSC classification due to its high prevalence, disability, and economic impact.
• Diagnosis and management are feasible in primary care settings using established guidelines and tools.
• Underdiagnosis and limited access to care contribute to avoidable hospitalizations, but pilot programs show positive outcomes with integrated primary care.

Conclusions:

• Migraine meets the criteria for a PCSC, offering a framework to reframe policy and resource allocation.
• Recognizing migraine as a PCSC can reduce avoidable hospitalizations and the global disease burden through timely diagnosis and equitable access.
• Strengthening primary care and integrating migraine management are crucial for better health outcomes and sustainable healthcare.