Doctors, Migraine Patients Not on the Same Wavelength

By Kate H. Gamble, Senior Editor

Findings from a new survey released by the National Headache Foundation (NHF) and GlaxoSmithKline indicate the migraine patients may not be getting the most of their medical visits. The implications could be significant for the 30 million migraine sufferers in the United States, of which 6 million treat the condition with prescription medication.

The survey, conducted online in November 2010 by Harris Interactive, included 1,218 diagnosed migraine patients taking prescription medications for their migraine attacks, as well as 533 physicians who treat between 5 and 10 migraine patients per week. The findings revealed disparities between what patients and physicians each reported typically discussing during office visits.

One reason for the gap may be that migraines are often addressed as part of a larger health discussion instead of as a point of focus. According to the survey, patients saw their primary migraine health care provider an average of 6 times in the past year, but 70% of these visits were related to other health conditions. Despite this, 63% of patients reported that migraines were discussed on visits where migraine was not the primary reason for the visit.

Although patients said the number one topic discussed was prescription migraine medication refills, physicians, on the other hand, reported that the number one topic discussed was the frequency of migraine attacks. Additional findings further illustrate a communication gap between patients and physicians:

• When it comes to migraine management, 78% of physicians said they typically discuss the timing of when patients take medications to treat their migraine, but just 18% report discussing this topic with their physicians;
• 83% of physicians said they routinely discuss personal migraine triggers, but only 38% of patients reported the same;
• 67% of physicians said they typically discuss the proper use of over-the-counter medications with their patients, but only 17% of patients reported having this discussion.

“The survey results show patients and physicians are having important conversations about migraine management; however, these conversations are not always robust or the primary purpose of a patient’s visit, making discussion priorities unclear,” said Robert Dalton, executive director of the National Headache Foundation, in a press release. “For example, patients may not always recall key pieces of information from these conversations or physicians may be misinterpreting what is being emphasized to the patient or the time doctors devote to a particular topic during these discussions.”

In the survey 41% of patients and 61% of physicians also said they wished they could have more discussions with each other about patients’ satisfaction with prescription migraine medications. Nearly half of physicians (46%) and more than a quarter of patients (28%), however, said that having more pressing health issues to discuss prevented them discussing prescription migraine medication options.

In addition to competing health priorities, 35% of physicians said they find it difficult to evaluate how well their patients’ primary acute prescription migraine medication works, primarily citing their patients’ inability to accurately recall or describe their recent migraine attack (50%) or how well their primary migraine medication worked (70%) as reasons why it is difficult to evaluate.

“By giving patients and doctors tools to guide conversations, we can help patients and doctors make the most of the limited time they have to talk about migraines,” said Robert Dalton, NHF. “Resources like a migraine diary or symptom tracker are worth the few minutes they take each day to complete since this information will enhance patients’ conversations with their physicians.”

Almost all physicians (96%) agreed that tools such as a migraine diary, medication usage tracker, pain severity scale or symptoms checklist would help them have more meaningful conversations with their patients about migraines. Likewise, 70% of patients said they would find such tools helpful when talking to their health care provider about migraines.