Headache from the Doctors' Perspective

Abstract

Background: General practitioners (GPs) and neurologists are involved in treating headache patients in Portugal. Having migraine themselves might influence the way they perceive and treat migraine patients. Objective: To identify clinicians' perceptions about migraine, their own headache status and management of their own migraine. Methods: An observational cross-sectional survey of GPs and neurologists using anonymous questionnaires including demographic data, headache and migraine status and migraine perception questions. Results: Of 348 respondent physicians, 20% were neurologists and 53% were females with an average age of 48 years. The majority had an interest in migraine and considered it disabling (93%), although 65-85% reported management difficulties, GPs more often than neurologists. Satisfaction with current treatment options was high (69-79%). 63 physicians suffered from migraine and 81% felt it influenced their perception of the disease. Portuguese physicians preferentially treat their own migraines with NSAIDs (33%), analgesics (29%) and triptans (20%). Conclusion: Portuguese physicians treating migraine patients have realistic perceptions about the disease and those with migraine feel their perception is influenced by their experience. Although reporting management difficulties, the majority of physicians are satisfied with current treatment options for migraine.

What is the actual prevalence of migraine?

“…was comparable to other survey-based studies of migraine in neurologists, although our response rate from neurologists and trainees of 76% is higher compared to most of these previous studies (Alstadhaug et al, 2012;Donnet et al, 2010;Evans & Evans, 2010;Evans & Ghosh, 2016;Evans et al, 2003Evans et al, , 2007Gil-Gouveia, 2014;Lu et al, 2006). As in previous studies, we demonstrated a significantly higher prevalence of migraine in neurologists (65.9%) than would be expected based on population prevalence studies.…”

“…To our knowledge, this is the first study examining migraine prevalence in neurologists to also include non‐neurologist and nonphysician groups for comparison. Our overall response rate of 51.7% was comparable to other survey‐based studies of migraine in neurologists, although our response rate from neurologists and trainees of 76% is higher compared to most of these previous studies (Alstadhaug et al., ; Donnet et al., ; Evans & Evans, ; Evans & Ghosh, ; Evans et al., , ; Gil‐Gouveia, ; Lu et al., ). As in previous studies, we demonstrated a significantly higher prevalence of migraine in neurologists (65.9%) than would be expected based on population prevalence studies.…”

“…Migraine prevalence in neurologists is higher compared to the general population with prevalence of up to 48.6% seen among neurologists (Alstadhaug, Hernandez, Naess, & Stovner, 2012;Donnet, Becker, Allaf, & Lantéri-Minet, 2010;Evans & Evans, 2010;Evans & Ghosh, 2016;Evans, Lipton, & Ritz, 2007;Evans, Lipton, & Silberstein, 2003;Gil-Gouveia, 2014;Lu, Wang, & Fuh, 2006). The reason for this is almost certainly better self-recognition of symptoms corresponding to migraine by those trained and experienced in the manifestations of migraine.…”

Portuguese Primary Care physicians response rate in surveys: A systematic review

“…Four different delivery modes were used in the included studies: e-mail, [17][18][19][20][21][22] postal, 16,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] personal contact (i.e., researchers delivered the questionnaire directly to the potential respondent) 15,37-50 and telephone-based surveys. 51 Subgroup analysis suggests that response rates differed in studies which used different survey delivery modes (interaction test p<0.0001).…”

“…We also analyzed the impact of different affiliations on response rate but we found no evidence supporting this influence (interaction test p<0.01). Twenty-one (21) studies were affiliated to healthcare provider, 15,[17][18][19][22][23][24][25][26]28,31,34,35,[37][38][39]41,42,44,46,48 fourteen to academic institutions, 21,27,29,30,32,33,36,40,43,45,47,[49][50][51] one related to regulatory institution 16 and other to the pharmaceutical industry. 20 Heterogeneity could not be explained by this subgroup analysis (I 2 =99% for academic institution affiliation and I 2 =98% for healthcare provider affiliation).…”