Few patients with migraine receive preventive treatment
Fewer than one in five patients with migraine who have 4 headache days or more each month go through the steps needed to receive preventive treatment, according to results from the OVERCOME study presented at the American Headache Society’s Annual Meeting.
“Migraine is a disabling neurological disease with an enormous socioeconomic impact,” Sait Ashina, MD, assistant professor of neurology and anesthesia at Harvard Medical School and Beth Israel Deaconess Medical Center, told Healio Primary Care. “Individuals with migraine often miss time with work, family and social activities and have poorer quality of life. Receiving an accurate diagnosis and treatment improves the patient’s pain [and] ability to function, thus reducing the burden of migraine.”
Ashina explained during the presentation that previous studies examining consulting, diagnosis and treatment of migraine did not examine both chronic and episodic migraine and many were conducted in a historical health environment. However, the OVERCOME study— a web-based survey conducted in a representative sample of the United States — “gives a contemporary view of the migraine health care landscape, which includes people with episodic as well as chronic migraine.”
Those included in the study had migraine based on International Classification of Headache Disorders-3 criteria or self-reported a migraine diagnosis to a health care provider. Patients who were eligible for recommended treatment had 4 headache days or more each month and had moderate headache-related disability.
Survey respondents were categorized based on the number of headache days they experienced each month — 4 to 7 days, 8 to 14 days and 15 or more days.
The researchers determined that 5,873 respondents with a mean age of 40.9 years were candidates for preventive treatment. Sixty-nine percent of patients sought care for migraine, and of those, 79.4% were diagnosed with migraine.
Ashina and colleagues found that just 15.4% of those included in the study sought care, received a diagnosis and received preventive treatment for migraine, with the prevalence of these patients ranging from 11.7% among those who had 4 to 7 headache days each month to 20.3% among those who had 15 or more headache days each month.
According to the researchers, seeking care was associated with being male, having health insurance and having severe headache disability. They also found that receiving a migraine diagnosis was associated with being female and having severe headache disability.
Receiving recommended preventive treatment, Ashina and colleagues found, was associated with having health insurance and severe headache disability.
Notability, Ashina explained during the presentation, seeking care for migraine exclusively at EDs, urgent care centers and retail clinics was associated with lack of diagnosis and not receiving preventive treatment.
“There are available acute and preventative therapies for migraine, but a large proportion of individuals who could potentially benefit from migraine prevention treatment remain untreated,” Ashina said. “These data emphasize the need for education for both patients and health care providers. For clinicians, it is important to know their patient’s reasons for seeking care, what impact migraine has on their life, and their set expectations for outcomes with migraine prevention.”
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Ashina S, et al. Abstract #833700. Presented at: American Headache Society Annual Meeting; June 15-30, 2020; Virtual.
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