Perspective on Migraine Patients

American Headache society

Sol Cavanagh, MDRaúl Carrea Institute for Neurological Research (FLENI)‐Headache specialized center

Buenos Aires ‐ Argentina

DISCLOSURESNothing to declare.

MIGRAINE PERSPECTIVE • Migraine is a chronic neurological condition with heterogeneous clinical 

presentation. It can cause a limitation of daily activities. • Perspectivemeans "look through" or "perceive“• Perspectivemeans "look through" or "perceive“. • A particular way of viewing things that depends on one´s experience and 

personality.• Is the ability to consider things in relation to one another accurately and• Is the ability to consider things in relation to one another accurately and 

fairly. 

3 or 43

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65 patients with MOH on a specialized headache clinic.‐Patients on specialized headache centers preferred personal information,expectations are very high and they considered that education and information

i

150 patients completed a 10 question survey about prevention treatmentat a specialized headache clinic. The most important thing were:‐Physisians involves them in the decision making of chossing thepreventive agent

EVIDENCEare important.‐51% expected to be cure. ‐57% effective prevention and fast relief episodes‐75% reduce frequency and intensity.

preventive agent.‐Adverse events explanation‐Published efficacy‐They don´t care taking 1 or more preventive treatment if it improvesefficacy‐weight and sedation are important.

20 patients with migraine at urban and rural general practice.3 focus groups of 6‐7 migraine patientsMayor influences in patients decisions about preventive treatment in migraine: ‐comunication between patients and physisiansActive or passive on decision making to iniciate prophylaxis.Assessing advantages or dissadvantagesSatisfaction with current migraine treatmentRelation with the physician. 

‐active involment of individual‐time to explaine adverse events‐treatment with higher efficacy rates. 

OBJECTIVES 

• Understand patients concerns about their migraine. • Know how much they understand their diagnosis and treatment.Know how much they understand their diagnosis and treatment.• Know if they understand the impact of life habits on their migraine.

• Understanding the concerns and reducing patients' fears regarding the use of prophylaxis could improve their adherence to treatment.Id tif i ti t´ k h l t d t th t th lt• Identifying patient´s weakness helps us to educate them at the consult and improve their migraine. 

METHODS• 12‐question survey was administered to 100 migraine patients.

• Age 21 62 years• Age 21‐62 years

Relevance/concernsHow much relevance the doctor  

gave to headache, if theyi i d

DiagnosisThey understand the diagnosis?commissioned. 

What is the most importantconcern about migraine (Health risk‐

limitation of activities‐mood changes‐medication)

They understand the diagnosis?Number of consultsAbnormal MRI?

medication)Environment comprehension

TreatmentAt the migraine attack if they wait or not

Life Habits and life qualityAt the migraine attack if they wait or notfor taking the pillHow they feel taking preventativemedicationIf they know about medication overuse

Impairs quality of life

Life Habits influence their migraine

If they know about medication overuse headache (MOH)Headache diary relevance

Evidence on survey questionsConcernsConcerns

Lifestyle and Life Quality

Diagnosis

TreatmentTreatment

RESULTSRelevance/concerns

SU S

44% Patients reported that their inquiry has not been valued by other doctors  specialties 67% Environment comprehension Daily activities

17%

What is the most important concernabout migraine?

67% Environment comprehension Daily activities limitation

Mood change35%

17%

Health Risk

Medication27%

21%

Diagnosis• 97.3% understood the diagnosis. • Consults numbers: Mean 5.7. • 40% preferred an abnormal brain MRI as an explanation. This 

means that they do not understand their diagnosis

Treatment• At the migraine attack if • How they feel taking• At the migraine attack ifthey wait or not for takingthe pill: 31% didn’t take the

• How they feel takingpreventative medication?

the pill: 31% didn t take the symptomatic medication immediately. 

Feel Safe

Feel Fear9% 5% 

• 83% knows what medication overuse 

No answer

Difficulties to 

62% 24% 

headache means. accomplish treatment

Life Habits and life quality

• Impairs quality of life:  98%

Lif H bit i fl th i i i 61%• Life Habits influence their migraine:  61%

• Headache diary relevance : 83% 

CONCLUSIONS• Migraine diagnosis remains undervalued in medical practice.• Wemust educate general practitioner in order to give relevance toWe must educate general practitioner in order to give relevance to 

migraine• Some patients expect to find abnormalities in imaging studies in order  to 

explain the problem or have concerns related to diagnosis and treatment. • Others are unaware that their lifestyle can influence the frequency of 

headaches. • Understanding the concerns and reducing patients' fears regarding the use 

of prophylaxis could improve their adherence to treatment.• Knowing patients perspective regarding migraine can help us to educate 

them in order to achieve a better outcome. 

LIMITATIONS• We enrolled only 100 patients• Selection bias

Thanks

Acknowledgements• Maria Teresa Goicochea• Maria teresa GutierrezMaria teresa Gutierrez• Fleni Pain section

F diFunding:• Raul Carrea Neurological Research Institute (Fleni), Buenos Aires,Argentina.