Reasons for Delayed Pain Management in Patients With Chronic Migraine: A Qualitative Study

Abstract

Background: Chronic migraine is often perceived as complex disease and difficult to manage. People with episodic migraine run the risk of developing chronic migraine, leading to great suffering for themselves, their families, and the larger society. The management of each attack may influence the development from episodic to chronic migraine. Aim: The aim of the present study was to explore experiences and management of migraine pain in patients with chronic migraine. Methods: Ten migraine patients participated in open interviews based on functional behavioural analysis within a cognitive behavioural framework. The interviews were analysed using systematic text condensation. Results: Participants’ experiences and management of chronic migraine pain was categorized under four concepts: Migraine pain signal, Hope of false alarm, Guiding assumption, and Delayed medical management. Conclusions: Difficulty distinguishing early migraine pain from other pain signals, neglect of migraine pain signals, and assumption of pain management can lead to delays in initiating emergency medication. Potentially early response to migraine pain signals could alleviate attacks.

The psychosocial impact of migraines on women and alternative therapies for migraine management

“…Feelings of sadness, frustration and vulnerability were also experienced by women with migraine without aura in a qualitative study that was conducted by Banciu and Bouleanu ( 2018 :27). In addition, other chronic migraine sufferers also felt anger and irritability about the frequency of migraine attacks (Banciu & Bouleanu 2018 :28; Persson et al 2021 :8). Suicidal thoughts during severe migraine attacks were experienced by chronic migraine sufferers (Persson et al 2021 :8).…”

“…In addition, other chronic migraine sufferers also felt anger and irritability about the frequency of migraine attacks (Banciu & Bouleanu 2018 :28; Persson et al 2021 :8). Suicidal thoughts during severe migraine attacks were experienced by chronic migraine sufferers (Persson et al 2021 :8). Similarly, suicidal thoughts were experienced by one participant because of the migraine severity.…”

“…Women with migraines without aura were reported to have experienced helplessness and frustration because of the unpredictability, invisibility and permanence of their migraines (Banciu & Bouleanu 2018 ). Female migraineurs also felt hopeless for the inability to manage their migraine pain (Persson et al 2021 :8). Two participants reported feeling insecure and hopeless about their ability to be independent in their lives because of a history of relying on others for assistance during their migraine attacks.…”

“…Several international studies have documented that migraineurs feel misunderstood, isolated, frustrated, and hopeless about their inability to manage their migraines. In addition, they indicate that migraineurs experience an associated decrease in their quality of life, and a negative social impact in the workplace, as well as in their personal and family relationships (Befus et al 2019 :3; Gibbs et al 2020 :1352; Leonardi & Raggi 2019 :6; Palacios-Ceña et al 2017 :9; Persson et al 2021 :8). Furthermore, the impact on their emotional health included anxiety, depression, frustration, anger, irritability, mood changes, hopelessness, feeling isolated, and concentration difficulties (Estave et al 2021 :1004).…”

“…It is an expensive condition to treat in South Africa, as healthcare systems fail to provide effective treatment for migraines, and this consequently results in decreased productivity in the socio-economic sector (Truter 2015 :450). Migraines are not always diagnosed or treated and most sufferers have had delays in diagnosis, inadequate treatment, and the resultant feelings of helplessness and depression (Banciu & Bouleanu 2018 :29; Persson et al 2021 :8). Migraineurs reported dissatisfactory or insufficient treatment, despite the variety of treatment approaches that are available (Malone et al 2015 :537).…”