{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:06:20Z","timestamp":1788537980380,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,4,4]],"date-time":"2017-04-04T00:00:00Z","timestamp":1491264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Headache disorders are widespread and disabling. They are common in Georgia, especially headache on \u226515 days\/month (HA\u2009\u2265\u200915), but there are no headache services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We established headache services meeting local needs, investigating feasibility, consumer uptake and satisfaction, and cost, with an exit strategy bequeathing effective, self-sustaining services that could be rolled out nationwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We created headache centres in Tbilisi and Gori offering free expert care for three visits over three months, and affordable medication thereafter. The primary outcome measure was the percentage of patients using the service beyond the free period \u2013 a measure of both satisfaction and sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1,445 patients (age 43.7\u2009\u00b1\u200912.4 years; 10.5% male), 49.8% had episodic migraine, 22.5% episodic tension-type headache, 25.7% HA\u2009\u2265\u200915 (24.5% overusing medication) and 2.0% trigeminal autonomic cephalalgias. Only 454 (31.4%) and 51 (3.5%) returned for second and third visits; in these, headache improved and treatment costs decreased. As information about the service spread, five other headache clinics opened in Tbilisi and Kutaisi (western Georgia). Pharmaceutical companies reduced prices (sumatriptan 100\u2009mg from US$7 to US$1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study failed to achieve its primary outcome, but sustainable headache services operating to international standards were successfully implemented nonetheless, with demand increasing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0333102417702131","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T02:42:41Z","timestamp":1491360161000},"page":"639-645","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Implementation of effective, self-sustaining headache services in the Republic of Georgia: Evaluation of their impact on headache-related disability and quality of life of people with headache"],"prefix":"10.1177","volume":"38","author":[{"given":"Gvantsa","family":"Giorgadze","sequence":"first","affiliation":[{"name":"Department of Neurology, LTD Aversi Clinic, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maka","family":"Mania","sequence":"additional","affiliation":[{"name":"Department of Neurology, LTD Aversi Clinic, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maka","family":"Kukava","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Medical Research, Ilia State University, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Dzagnidze","sequence":"additional","affiliation":[{"name":"Department of Neurology, S Khechinashvili University Hospital Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterine","family":"Mirvelashvili","sequence":"additional","affiliation":[{"name":"International School of Public Health, Tbilisi State Medical University, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J","family":"Steiner","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Division of Brain Sciences, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaza","family":"Katsarava","sequence":"additional","affiliation":[{"name":"Department of Neurology, Evangelical Hospital Unna, Germany"},{"name":"University of Duisburg-Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,4,4]]},"reference":[{"key":"bibr1-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"bibr2-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60692-4"},{"key":"bibr3-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-015-0544-2"},{"key":"bibr4-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-015-0496-6"},{"key":"bibr5-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c34abb"},{"key":"bibr6-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1177\/0333102412438977"},{"key":"bibr7-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2007.01288.x"},{"key":"bibr8-0333102417702131","unstructured":"World Health Organization.\n                      Lifting the burden. Atlas of headache disorders and resources in the world 2011\n                      . Geneva: World Health Organization, www.who.int (2011, accessed 29 October 2016)."},{"key":"bibr9-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-011-0398-1"},{"key":"bibr10-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-011-0342-4"},{"key":"bibr11-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(04)00703-3"},{"key":"bibr12-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-005-0241-7"},{"key":"bibr13-0333102417702131","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1007\/s10194-007-0353-8","volume":"8","author":"Steiner TJ","year":"2007","journal-title":"J Headache Pain"},{"key":"bibr14-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-011-0320-x"},{"key":"bibr15-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-012-0263-1"},{"key":"bibr16-0333102417702131","volume":"8","author":"Steiner TJ","year":"2007","journal-title":"J Headache Pain"},{"key":"bibr17-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798006667"},{"key":"bibr18-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.179.6.540"},{"key":"bibr19-0333102417702131","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"bibr20-0333102417702131","unstructured":"National Statistics Office of Georgia; www.geostat.ge (accessed 29 October 2016)."}],"container-title":["Cephalalgia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0333102417702131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0333102417702131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0333102417702131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:47:26Z","timestamp":1777387646000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0333102417702131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,4]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1177\/0333102417702131"],"URL":"https:\/\/doi.org\/10.1177\/0333102417702131","relation":{},"ISSN":["0333-1024","1468-2982"],"issn-type":[{"value":"0333-1024","type":"print"},{"value":"1468-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,4]]}}}