CHICAGO and RESEARCH TRIANGLE PARK, N.C. — A national survey released by the National Headache Foundation (NHF) and GlaxoSmithKline (GSK) revealed disparities between what migraine headache sufferers and physicians say they discuss during office visits, including their prescription medications and over-the-counter drugs.
GSK and NHF said Thursday that the Harris Interactive poll indicates that migraine patients could be doing more to get the most out of their medical visits. They reported that there are nearly 30 million migraine sufferers in the United States, including 6 million treating with prescription drugs.
The survey included 1,218 diagnosed migraine patients taking prescription medications for their migraine attacks as well as 533 doctors who treat between five and 10 migraine patients per week.
One reason for the disconnect may be that migraines are often addressed as part of a larger health discussion instead of as a point of focus, according to the study. Patients surveyed saw their primary migraine health care provider an average of six times in the past year, but 70% of the visits were related to other health conditions. Still, 63% of patients reported that migraines were discussed on visits where migraine was not the primary reason for the visit.
Patients said the No. 1 topic discussed during visits was prescription migraine medication refills, yet physicians said the primary topic discussed was the frequency of migraine attacks. Other findings illustrating the communication gap included the following:
• When it comes to migraine management, 78% of doctors said they typically discuss the timing of when patients take medication(s) to treat their migraine, but 18% of patients report discussing that topic with their physicians.
• 83% of physicians said they routinely discuss personal migraine triggers, but only 38% of patients reported the same.
• 67% percent of doctors said they typically discuss the proper use of OTC medications with their patients, but only 17% of patients reported having that discussion.
"The survey results show patients and physicians are having important conversations about migraine management. However, these conversations are not always robust or the primary purpose of a patient’s visit, making discussion priorities unclear," explained Robert Dalton, executive director of the National Headache Foundation. "For example, patients may not always recall key pieces of information from these conversations, or physicians may be misinterpreting what is being emphasized to the patient or the time doctors devote to a particular topic during these discussions."
Many patients (41%) and physicians (61%) also said they wished they could have more discussions with each other about patients’ satisfaction with prescription migraine medications. Nearly half of physicians (46%) and more than one-quarter of patients (28%), however, said that having more pressing health issues to discuss prevented them discussing prescription migraine medication options.
Just over one-third of doctors (35%) said they find it difficult to evaluate how well their patients’ primary acute prescription migraine medication works, citing their patients’ inability to accurately recall or describe their recent migraine attack (50%) or how well their primary migraine medication worked (70%) as reasons why it is difficult to evaluate.
"By giving patients and doctors tools to guide conversations, we can help patients and doctors make the most of the limited time they have to talk about migraines," Dalton added. "Resources like a migraine diary or symptom tracker are worth the few minutes they take each day to complete since this information will enhance patients’ conversations with their physicians."
Almost all physicians (96%) agreed that tools such as a migraine diary, medication usage tracker, pain severity scale or symptoms checklist would help them have more meaningful conversations with their patients about migraines. Similarly, 70% of patients said they would find such tools helpful when talking to their health care provider about migraines.
