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Migraine Sufferers May Not Be Receiving Most Effective Treatment

The majority of people who suffer from migraine headaches, characterized as painful, disabling and recurring headaches, may not be receiving the most effective treatments, according to a study published this month in Headache.

The study “Health Care Utilization in Patients with Migraine”, conducted by researchers at Wake Forest University School of Medicine, reviewed National Ambulatory Medical Care Survey (NAMCS) data from 1990 to 1998 to assess the demographics of patients seen with a diagnosis of migraine, the types of physicians they saw, and the medications used to treat migraine. NAMCS is an ongoing survey of office-based physicians conducted by the Division of Healthcare Statistics, the National Center for Health Statistics, and the Centers for Disease Control and Prevention.

“Our research shows that, while patient visits for migraine have increased, over 60 percent of those patients are seen by a primary care physician, compared to less than 20 percent seen by a neurologist,” said Cormac O’Donovan, M.D., assistant professor of Neurology at Wake Forest and senior author of the study. However, studies have shown that patients report more satisfaction and better treatment outcomes when they were treated by a specialist.

Increased awareness of the diagnosis and the recent availability of newer and more effective drugs such as Sumatriptan and antiepileptic drugs may account for the increased visits, said Maria Sam, M.D., assistant professor of neurology at Wake Forest and senior researcher on this study.

In the primary care setting, migraines have often been treated with analgesics and drugs that may be habit forming.

“Education of both physicians and the public about new and effective treatments will increase the number of those finding relief of their migraines and decrease the number of those using potentially habit- forming medications,” said O’Donovan.

Similar studies showed that patients who took drugs like Sumatriptan, which were a minority of patients in this study, missed fewer days of work, had fewer health care visits, lower health care costs and fewer days in which their normal activities were altered by a headache.

Migraines affect an estimated 30 million people in the U.S. The prevalence is 6 percent in men and 15-18 percent in women.

Most migraine sufferers are in the 30- to 59-year age group, and as many as 50 percent are undiagnosed.

“While the majority of patients with migraine are still being seen by primary care physicians, these patients may benefit from referral to a specialist, or by programs aimed at educating primary care providers in the use of new treatment options,” said O’Donovan.

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Contact: Jonnie Rohrer, jrohrer@wfubmc.edu, (336) 716-6972, Karen Richardson, krchrdsn@ wfubmc.edu, or Barbara Hahn, bhahn@wfubmc.edu, 336-716-4587.

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