Healthcare providers' perspectives on headache care in Azerbaijan: results of a national cross-sectional survey.

Background: Headache disorders are prevalent in Azerbaijan, yet data on system-level care delivery, treatment options, and provider preparedness remain scarce. Using a national, cross-sectional survey of healthcare professionals, this study aimed to assess the current state of headache care in Azerbaijan. Methods: A national, cross-sectional survey was conducted using a convenience sampling approach, targeting healthcare professionals involved in headache management across Azerbaijan. Data were collected between December 2024 and May 2025, 333 healthcare professionals, including neurologists (25.9%), general practitioners (27.9%), pharmacists (21.9%), and pediatricians (24.3%). Data were collected using a modified HARDSHIP-based questionnaire that addressed provider training, access to medications, treatment practices, access to migraine-specific resources, and perceptions of patient demographics. Descriptive statistics and comparative analyses were performed to describe regional and professional disparities. Results: All participating healthcare professionals reported receiving some form of training in headache care. Within the survey sample, respondents were predominantly based in urban hospital settings, whereas relatively few practiced in rural areas and none reported working in community-based healthcare centers. These findings suggest possible geographic differences in the distribution of participating healthcare professionals; however, because the survey was based on convenience sampling, they should be interpreted as descriptive observations rather than evidence of nationally representative workforce disparities. The most frequently reported acute treatments were NSAIDs (67.3%) and paracetamol (27.6%). The most commonly reported preventive medications were amitriptyline (75.7%), magnesium (51.1%), gabapentin (24.6%), and valproate (24.3%). Migraine-specific therapies such as triptans were reported infrequently (15.3%), whereas beta-blockers were not reported to be used for migraine prevention. Newer migraine-specific therapies, including anti-CGRP monoclonal antibodies and gepants, were not available within the national healthcare system at the time of data collection. Conclusion: This national provider-based survey provides the first perception-based overview of headache care in Azerbaijan and identifies priorities for future health-service planning. Although participating healthcare professionals reported exposure to headache-related training and access to commonly used medications, the findings suggest potential geographic differences in provider distribution and limited use of migraine-specific therapies. Because the survey was based on healthcare providers' perceptions derived from a convenience sample, the findings should be interpreted as complementary to, rather than substitutes for, patient-level or administrative health-system data. Future nationally representative studies are needed to guide the development of structured, evidence-based headache services.