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Migraine not only affects individual sufferers, but also entire families

SAN FRANCISCO — Children of parents who suffer from migraine report that their parents’ illness has a moderate impact on their lives, according to data presented at the American Headache Society Annual Scientific Meeting.

The greatest impacts the illness had on children included lack of daily help, global well-being and parent-child relationship, according to the data.

“We didn’t know enough about how migraine impacts family members,” Elizabeth K. Seng, PhD, an assistant professor of psychology at Yeshiva University and a research assistant professor of neurology at Albert Einstein College of Medicine, told Healio Internal Medicine. “Chronic diseases impact the lives of people who are family members. There’s all sorts of potential burdens that family members of people with chronic illness and caretakers work with, such as burden of daily help, impact on social life, and impact on personal future. And we really knew almost nothing about that impact in the children of people with migraine. No one had ever asked children their perspective; we had talked to people with migraine about how they felt their children were impacted, but we had never actually talked with children themselves.”

Seng and colleagues utilized a revised parental illness impact scale (PIIS-R) to assess the impact of parental migraine on children on things such as emotional impact, social impact, communication and understanding, friend’s reaction and global well-being.

Researchers recruited family pairs at their practices, as well as using phone screenings and online methods.

A parent had to have physician-diagnosed migraine and the children had to be aged 11 to 17 years and live at home full-time.

Two-hundred and forty-five parents were contacted and assessed for eligibility. After excluding for several factors, 40 parent-child pairs were analyzed in the survey.

Median age of the parents involved in the study was 43.5 years (97.5% female) and more than half (77.5%) were married.

Fifty-five percent of the respondents reported that their partner was considered the higher earner in terms of income.

The respondents also reported suffering from a median of 6.8 headaches per month.

The median age for children who responded to the survey was 13.6 years (51.2% male).

Using a 5-point rating system, which considered 5 to be least impactful and 1 to be most impactful, children reported that global well-being (3.3), parent-child relationship (3.5), lack of daily help (3.8) and emotional impact (3.8).

Researchers reported that parents mostly reported similar results as to what they believed was most impactful in their children.

Parents agreed that lack of daily help (P = .011), emotional impact (P = .016), and global well-being (P = .011) were most impactful.

“We anticipated there would actually be more differences between parents and children than we saw,” Seng said. “There’s two ways this could be viewed. You could say, ‘How much do an individual parent and child agree?’ You could also ask the question, ‘On average, do parents perceive more burden or less burden than their children?’ We expected parents and children not to agree very much and that overall, parents would perceive more burden than their children. What we found was that parents and children had a couple of these areas where they really didn’t agree very much at all. But overall there weren’t large differences on average between how much burden parents and children perceived. Even though individual child-parent relationships might not necessarily be congruent, we couldn’t generalize and say, on average parents perceive higher burden.”

Seng noted that an interesting finding from the study was that 60% of the children within the survey reported problematic headache and almost half described the headaches as being consistent with migraine.

“Treating the family unit may be an important way to improve everyone’s management of migraine,” she said. “I am hoping to move toward evaluating some novel ways for providers to be able to treat parent and child together with co-visits or visits where providers are able to talk to each other, so we could have better management, not just of the person in a family who has migraine, but the family unit where people are suffering from migraine.”

Seng added that it would take a provider who would feel comfortable in seeing both adults and children to be able to effectively treat the family unit together.

“There are not enough UCNS-certified headache specialists in this country,” she said. “If you ask that question for pediatrics, we desperately need neurologists to decide that children with headache need to be treated and that’s what they want to do with their lives. There are an impressive number of enthusiastic young, pediatric headache specialists and my hope is that we can start to build relationships between pediatric and adult neurologists so that a family may be able to come to clinic on the same day, both parent and child can be seen by providers and those providers are people who are in contact with each other and will be able to share information about the family which is called a co-located model so that the family can get better treatment. Obviously, it would be ideal for treatment teams to be able to meet with the patients back-to-back in the same room with the same provider but there are only a handful of very special headache providers who are able to do that.” – by Ryan McDonald

Reference:

Seng EK, et al. OR-07. Presented at: American Headache Society Annual Scientific Meeting; June 28-July 1, 2018; San Francisco

Disclosures: Seng reports serving as a consultant with Eli Lilly and GlaxoSmithKline.