Professionals and key activities in the different subpathways of the headache patient care process
| # | Subpathway | Person(s) involved | Activities |
| 1 | PC | PC, GP and nursing staff (follow-up) | Diagnosis (differential and request for tests), therapeutic approach, health education, monitoring and possible referral to ND or ED. |
| 2 | ED | EP | Triage, initial assessment (history and examination), possible complementary tests, and referral to PC, ND or SHU. Patients admitted to the emergency observation unit under duty doctor when there is no neurologist on call. |
| 3 | ND | Neurologist | Headache diagnosis (history, physical and neurological examination), differential diagnosis (request for complementary tests), prescription of hygienic-dietary measures, pharmacological treatment, delivery of headache diary, health education, identification of headache-related disability (MIDAS and HIT-6 scales), coordination with PC and ED and referral to SHU for advanced therapies. |
| 4 | SHU | Neurologist | Request for additional tests (laboratory and imaging), diagnosis (history and examination), treatment, follow-up, possible indication of hospital admission, referral to DH, ND or others and discharge to PC. |
| 5 | Hospitalisation | Neurologist and nursing staff | Differential diagnosis, specific diagnostic tests, therapeutic approach, treatment of the underlying process (secondary headaches) and referral to ND or PC for follow-up. |
| 6 | Outpatients | Neurologist and nursing staff | Diagnostic and therapeutic approach (lumbar puncture, parenteral treatment). |
| 7 | Governance and management | Administrators, senior and middle management | Guarantee the availability of the necessary means for adequate care, the appropriate professional competencies of the personnel involved, and the ongoing evaluation of the structure, processes and outcomes to ensure comprehensive, coordinated and accessible healthcare for the headache patient. |
DH, day hospital; ED, emergency department; EP, emergency physician; GP, general practitioner; HIT-6, six-item headache impact text; MIDAS, migraine disability assessment scale; ND, neurology department; PC, primary care; SHU, specialised headache unit.