Migraine patients’ journey until a tertiary headache center: an observational study

Abstract

BackgroundMigraine diagnosis is based on clinical aspects and is dependent on the experience of the attending physician. This study aimed to describe the patients journey profile until they start their experience in a tertiary headache center.MethodsIn a cross-sectional study, medical charts from migraine patients were reviewed to describe which treatments, procedures and follow-up strategies are performed until the first appointment with a headache specialist. Patients from both sexes, ≥18 years old, which came to their first visit from March to July 2017 were included. Sociodemographic information, headache characteristics, diagnostic methods previously used, clinical history, family history and the treatments previously used were assessed in the first appointment with a specialist. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were also applied. Descriptive analyses were performed to describe the sample profile and statistical tests were used to evaluate factors associated with the type of migraine (chronic or episodic).ResultsThe sample consisted of 465 patients. On average, the pain started 17.1 (SD = 11.4) years before the first appointment with a headache specialist. Most of patients were classified as having chronic migraine (51.7%), with an average frequency of 15.5 (SD = 9.9) days per month. Regarding patients’ journey until a specialist, most patients were submitted to laboratory tests (74.0%), cranial tomography (66.8%) and magnetic resonance imaging (66.8%) as diagnostic methods, and preventive drugs (70.2%) and acupuncture (61.0%) as treatments. After stratification by migraine type as episodic or chronic, patients with chronic migraine were submitted to more magnetic resonance imaging test, acupuncture, psychotherapy, used preventive drugs, and reported to have used topiramate without beneficial effects.ConclusionsBrazilian patients with migraine experiment a long journey until getting to a headache specialist and are submitted to a great number of unnecessary exams, especially those with chronic migraine.

Care Among Migraine Patients in a Commercially Insured Population

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“Triaging” Chronic Migraine Patients in Need of CGRP(r) Monoclonal Antibodies

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Acupuncture and Its Role in the Treatment of Migraine Headaches

“…Migraines are difficult to treat, and current treatment options have many unwanted side effects and can even exacerbate headache pain in those with chronic migraines [ 2 ]. In addition, many patients who experience migraines encounter difficulties in getting correctly diagnosed and subsequently in accessing the care that they need [ 3 ]. This has led many clinicians and researchers to turn to other forms of treatment, such as acupuncture, as an alternative source of pain management and healing for those who suffer from migraine refractory to standard pharmacological treatment.…”