Awareness of headache and of national headache society activities among primary care physicians – a qualitative study

Gantenbein, Andreas R.; Jäggi, Christian J.; Sturzenegger, Matthias; Gobbi, Claudio; Merki‐Feld, Gabriele S.; Emmenegger, Mark; Taub, Ethan; Sándor, Péter

doi:10.1186/1756-0500-6-118

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…[38][39][40] Indeed, one study found that primary care physicians are interested in enhanced headache care education. 41 Further, lack of understanding of patients with migraine breeds persistent stigma towards these patients and potential provider depersonalization, which may be mitigated through provider education. 29,42 Limitations of this study include that our interview participants clinically practice in fee for service healthcare organizations.…”

Section: Themes Illustrative Quotesmentioning

confidence: 99%

Essential components of care in a multidisciplinary headache center: Perspectives from headache neurology specialists

Goldman

Damush

Kuruvilla³

et al. 2022

Headache

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Background and Objective: Comprehensive headache care involves numerous specialties and components that have not been well documented or standardized. This study aimed to elicit best practices and characterize important elements of care to be provided in multidisciplinary headache centers.Methods: Qualitative, semi-structured telephone interviews with a purposive sample of headache neurology specialists from across the US, using open-ended questions.Interviews were recorded, transcribed, and coded. Coded data were further analyzed using immersion/crystallization techniques for final interpretation.Results: Mean years providing headache care was 17.7 (SD = 10.6). Twelve of the 13 participants held United Council for Neurologic Subspecialties headache certification. Six described their practice site as providing multidisciplinary headache care.Participants explained most of their patients had seen multiple doctors over many years, and had tried numerous unsuccessful treatments. They noted patients with chronic headache frequently present with comorbidities and become stigmatized. All participants asserted successful care depends on taking time to talk with and listen to patients, gain understanding, and earn trust. All participants believed multidisciplinary care is essential within a comprehensive headache center, along with staffing enough headache specialists, implementing detailed headache intake and follow-up protocols, and providing the newest medications, neuromodulation devices, botulinum toxin injections, monoclonal antibodies, nerve blocks and infusions, and treatment from a health psychologist. Other essential services for a headache center are other behavioral health practitioners providing cognitive behavioral therapy, mindfulness, biofeedback and pain management; and autonomic neurology, neuropsychology, vestibular audiology, sleep medicine, physical therapy, occupational therapy, exercise physiology, speech therapy, nutrition, complementary integrative health modalities, and highly trained support staff.| 307 HEADACHE INTRODUC TI ONComprehensive specialty headache care involves numerous processes, components, and workflow protocols intended to promote delivery of high-quality care. However, these have not been standardized or clearly delineated. Over the years, initiatives have arisen to define and measure quality in headache care, stemming from more general explications of quality in health care. 1 Reviews of quality in headache care include multiple dimensions of quality indicators, standards, and guidelines for outcomes and safety, along with structure, processes, and outcomes of patient care and services. [2][3][4][5] The European Headache Federation, in conjunction with the Lifting The Burden campaign, 6 have proposed criteria for specialized headache centers, including offering multidisciplinary headache care. 7 Currently, there is no certifying body or definitive list of core components requisite or suggested for headache centers in the United States (US).Multidisciplinary treatment has been s...

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Section: Themes Illustrative Quotesmentioning

confidence: 99%

Essential components of care in a multidisciplinary headache center: Perspectives from headache neurology specialists

Goldman

Damush

Kuruvilla³

et al. 2022

Headache

View full text Add to dashboard Cite

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“…In Europe, migraine affects 12%-28% people in a period of their lives, with about 6%-15% adult men and 14%-35% adult women getting at least 1 migraine yearly (6). It has been estimated that migraine is the most costly neurological disorder in the European Community, costing more than €27 billion per year (7,8). In the United States, the direct cost of migraine on the economy reaches up to $17 billion per year (2).…”

mentioning

confidence: 99%

“…Migraine diagnosis is based on signs and symptoms in history taking and the characteristic features of headaches (7). Generally, neuroimaging tests are not necessary to diagnose migraines (8,9). It is believed that a substantial number of people with migraines remain undiagnosed.…”

mentioning

confidence: 99%

Awareness of Migraine Among Primary Care Physicians in Turkey: A Regional Study

Gültekın¹,

Balcı²,

İsmailoğulları³

et al. 2016

Arch Neuropsychiatr

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Introduction: Migraine is a primary headache that involves genetic and environmental factors. In studies conducted in different countries, migraine was shown to be underdiagnosed, treated insufficiently, and highly related to disability. The primary aim of this study was to identify the competence in making a diagnosis of migraine by primary care physicians who provide basic health care to patients. Methods: Primary care physicians (266 individuals) working in the primary health service centers located within the borders of Kayseri province were included in our study. The research was conducted by using techniques such as face-to-face meetings with the primary care physicians and by participants filling in questionnaires. A neurologist evaluated the questionnaire form. The information provided by the participants was evaluated according to the migraine without aura diagnostic criteria prepared by the International Headache Society (ICHD-3 Beta). Results: Only 10.5% participants were able to give the complete diagnostic criteria of migraine without aura. The most well-known properties were unilateral (53.4%) and pulsating headaches (47%). Conclusion: This study showed that educational programs are required regarding migraines for primary care physicians, supported by complete educational material.

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“…We achieved a similar, slightly higher, degree of participation in the current optometrist cohort (80%). This may be due to the ability for optometrists to claim compulsory continuing professional development points (as a self‐directed learning activity), which was not explicitly offered by previous survey studies 16 . Our high degree of participation in the study may also be, at least in part, due to the higher‐than‐expected self‐reported history of migraine (43/98 respondents, 44%) in initial survey respondents (and 13/31 respondents, 42%, with history of migraine in the follow‐up survey) relative to the general population prevalence of ~15%, 1 which may have introduced a selection bias toward participation in a migraine‐related survey.…”

Section: Discussionmentioning

confidence: 99%

“…However, counter to this finding, most respondents were unaware of validated migraine screening tools that could assist in migraine screening in primary care, and were motivated to learn more about it and participate in our pilot implementation program. A previous survey of primary care physicians in Switzerland 16 demonstrated that approximately 3‐quarters (255 of 350 participants) of survey participants expressed an interest in further education about headache, with half of the group providing their email address to receive further information. We achieved a similar, slightly higher, degree of participation in the current optometrist cohort (80%).…”

Section: Discussionmentioning

confidence: 99%

Migraine Screening in Primary Eye Care Practice: Current Behaviors and the Impact of Clinician Education

et al. 2020

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Background Migraine is underdiagnosed and undertreated. Optometrists are primary eye care providers, who regularly encounter people with migraine as an incidental finding during routine eye examinations, or when patients present to rule out whether visual or ocular problems are contributing to headache symptoms. Knowledge and use of a migraine screening tool in optometric practice is, therefore, important to be able to identify and refer people with migraine for appropriate management. Objective We sought to investigate optometrists’ current behaviors regarding screening for migraine, and to assess the effectiveness of an educational resource in promoting the use of a 3‐item validated migraine screening questionnaire, the ID‐Migraine. Methods We first conducted a cross‐sectional study using a survey to assess optometrists’ current knowledge and behaviors about migraine screening and willingness to participate in a pilot implementation program. Participants who provided their contact details were invited to watch an online educational resource about a validated migraine screening tool. After 6 weeks, these participants were invited to participate in a follow‐up cohort study involving a survey to assess the effectiveness of the educational resource. Results Ninety‐eight optometrists completed the initial survey as part of the cross‐sectional study. We found that most optometrists actively asked patients about migraine (79/98 respondents, 81%) as part of routine eye examinations and self‐rated themselves as confident in identifying migraine (71/98 respondents, 72%). However, the majority (90/98 respondents, 92%) were not aware of any validated migraine screening tools. Seventy‐eight respondents provided their contact details to receive information about the subsequent cohort study. In response to the follow‐up study survey (31/78 participants, 40%), 45% (14/31 respondents) of participants self‐reported using the ID‐Migraine tool after watching our educational video, and most of these participants (12/14 respondents, 86%) were likely or extremely likely to continue to use the tool in their practice. Conclusions From our initial cross‐sectional survey, we conclude that optometrists do not currently use validated screening tools for migraine and as such, there is an opportunity for continuing professional development in this area. Our follow‐up cohort study demonstrates that educating optometrists on the importance and utility of a validated migraine screening tool is achievable with a relatively simple, low‐time investment intervention (an online educational video). Such education may result in improved identification of migraine, which may lead to improved management.

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Awareness of headache and of national headache society activities among primary care physicians – a qualitative study

Cited by 5 publications

References 11 publications

Essential components of care in a multidisciplinary headache center: Perspectives from headache neurology specialists

Essential components of care in a multidisciplinary headache center: Perspectives from headache neurology specialists

Awareness of Migraine Among Primary Care Physicians in Turkey: A Regional Study

Migraine Screening in Primary Eye Care Practice: Current Behaviors and the Impact of Clinician Education

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