Management of Migraine and the Accessibility of Specialist Care: Findings from an Extended Multinational Survey (My Migraine Center Survey)

Abstract

Introduction: The parent study was a survey in 28 headache centers (6 countries) which identified five potential root causes for long waiting lists that limit patient access to specialist care. Here we performed an extension of the parent study to increase the panel of centers contacted, the representativeness of the analysis, and the statistical validity of the results, and to explore the role of dedicated headache clinics, triage, and specialized nurses. Methods: We conducted a 19-question survey using a sample of 239 headache centers (16 countries). The five-area framework identified Digital Features To view digital features for this article go to

Global, regional, and national burden of migraine in 204 countries and territories, 1990 to 2019

“…23 On the other hand, many people affected by migraine are unable to access or do not receive appropriate care, even in high-income countries. 6,40,42…”

Telephone follow‐up on treatment and patient satisfaction at a Danish tertiary headache center: A prospective study

“…There were no changes in the ISI score (TeII: 1.0, interquartile range [IQR] 6; p = 0.152; BAU: 0.5, IQR 4.5; p = 0.824), HADS-Anxiety score (TeII: −5, IQR 5.3; p = 0.186; BAU: 1.0, IQR 4.0; p = 0.445), or HADS-Depression score (TeII: 0.0, IQR 3.0; p = 0.163; BAU: 0.0, IQR 2.0; p = 0.303) in any of the groups. There was a higher degree of patient satisfaction in the TeII group compared with the BAU group in treatment (median [IQR] score 4 [3][4][5] vs. 3 [3][4], p < 0.001), headache improvement (median [IQR] 3 [2][3][4] vs. 2 [1][2][3], p = 0.002), the headache program (median [IQR] 4 [3][4][5] vs. 3 [3][4], p < 0.001), and information (median [IQR] 4 [3][4][5] vs. 3 [3][4], p = 0.005).…”

“…Only 1% may require treatment at tertiary headache centers with specialized medical doctors and advanced multidisciplinary care 4 . However, access to specialized headache centers is challenged by a long waiting time to the first visit and delay in follow‐up visits 5 . Furthermore, patients may not comply with the treatment plan and stop the pharmacologic treatment because of lack of efficacy, adverse effects, or doubt about dosage of the medication 6 .…”

“… 4 However, access to specialized headache centers is challenged by a long waiting time to the first visit and delay in follow‐up visits. 5 Furthermore, patients may not comply with the treatment plan and stop the pharmacologic treatment because of lack of efficacy, adverse effects, or doubt about dosage of the medication. 6 Alarmingly, a large retrospective study found that adherence to the initial oral migraine preventive was only 25% after 6 months with approximately half of the patients with migraine discontinuing after 60 days.…”

Migraine, Migraine Disability, Trauma, and Discrimination in Sexual and Gender Minority Individuals

“… 12 - 15 SGM people experience a higher risk of mental and physical disability compared with heterosexual, cisgender (i.e., nontransgender) peers 16 , 17 and have a disparate prevalence of mental health concerns, including higher rates of depression, anxiety, and PTSD. 17 - 19 It is also unknown whether SGM individuals experience barriers to accessing neurologic care for the treatment of migraine, such as prolonged wait times, 20 issues with health insurance, 21 or not being offered appropriate treatment options. 22 Understanding the current state of migraine care is an essential step toward improving the neurologic health of SGM individuals.…”