PO-53 | Managing chronic primaryhHeadache in Lombardy: insights from the ‘PERLA’ project
Grazia Sances,1 Claudia Sulmona,1 Natascia Ghiotto,1 Daniele Martinelli,1 Licia Grazzi,2 Alberto Raggi,2 Danilo Antonio Montisano,2 Matilde Leonardi,2 Giulia Gandini,2 Renata Rao,3 Alessandro Padovani,3 Alessandro Amorosi,5 Cristina Tassorelli,1,5 on behalf of Rete Regionale Cefalee Lombardia | 1Headache Science and Neurorehabilitation Unit, IRCCS Mondino Foundation Pavia, Italy; 2Headache Center, IRCCS Fondazione Istituto Neurologico Carlo Besta, Milan, Italy; 3ASST Spedali Civili di Brescia, Italy; 4Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; 5Struttura Reti Clinico-Assistenziali e Organizzative e Ricerca, U.O. Polo Ospedaliero Direzione Generale Welfare, Regione Lombardia, Italy
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Background: The PERLA project (Integrated and Coordinated Management of Patients with Chronic Primary Headache) was developed in accordance with Law 81/2020, which formally recognises chronic primary headache as a social disease in Italy. In Lombardy, the project engaged the entire Regional Headache Network, comprising of 38 headache centres coordinated by three tertiary-level institutions, to address the growing need for standardised and efficient headache management in adults.
Methods: The project was structured around several key components: data collection through two surveys, a retrospective one, covering 2023, and a prospective one, spanning five months in 2024; the development of accredited online training courses targeting various healthcare professionals, and the design of a regional diagnostic-therapeutic care pathway (PDTAr). Additionally, patient engagement was promoted through a dedicated website and social media channels, featuring educational content, expert-led video modules, and a podcast series produced in collaboration with patient associations.
Results: The collected data provided an essential regional overview of chronic headache incidence, patient profiles and clinical workloads. The training initiatives represented a valuable opportunity to enhance clinical competence among healthcare professionals. The communication strategies promoted greater patient awareness and engagement. All resources remain freely accessible for continued use. Furthermore, the PDTAr is now disseminated across all centres within the network and the general practitioners, to improve the patient’s journey and establish a standardised approach for the management of chronic headache.
Conclusion: The PERLA project has introduced a comprehensive system for the integrated management of patient-centred headache care in the Lombardy region. Its cornerstones encompass network integration of different-level headache care facilities, continuous competency-based professional development and systematic patient engagement initiatives. These elements are designed to enable early patient access and improve quality, efficiency and continuity of healthcare delivery.
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