Migraine Patients and Doctors View Appointments Differently

Patient Expert

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A survey conducted by the National Headache Foundation (NHF) and GlaxoSmithKline (GSK) confirms that Migraine patients and doctors view the results of appointments differently, and we Migraineurs could be doing more to get the most our of our medical visits.

The survey:

The survey was conducted online by Harris Interactive in 2010. The survey included 1,218 Migraine patients who were taking prescription medications for their Migraine attacks and 533 doctors who treat five to 10 Migraine patients per week.

According to the survey:

  • Patients had seen their primary Migraine health care provider an average of six times in the previous year, but 70% of those visits were related to other health conditions.
  • Sixty-three percent of patients reported that Migraines were discussed during visits where Migraine wasn't the primary reason for the appointment.

The survey showed disparities between what patients reported and what doctors reported:

  • Patients said the number one topic discussed was prescription Migraine medication refills, but doctors said the number one topic was the frequency of Migraine attacks.
  • Seventy-eight percent of doctors said they typically discuss with patients when to take their medications to treat Migraine, but only 18% of patients reported discussing this topic.
  • Eighty-three percent of doctors said they typically discuss Migraine triggers, but only 38% of patients said this topic was discussed.
  • Sixty-seven percent of doctors said they typically discuss the proper use of over-the-counter medications with their patients, but only 17% of patients reported this being a topic of discussion.

Why is it difficult for doctors to evaluate how well our primary acute Migraine medications work?

Thirty-five percent of doctors said they find it hard to evaluate how well the medications we take when we get a Migraine work because of our inability to accurately remember or describe our recent Migraine attacks (50%) or how well the medication worked (70%).

Nearly all the doctors (96%) agreed that tools such as a Migraine diary, medication usage tracker, pain severity scale, or symptom checklist would help them have more productive conversations about Migraine with their patients. Seventy percent of patients said they'd find these tools helpful when talking with their doctors about Migraines.

Robert Dalton, executive director of the NHF, said,

"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. 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 a physician devotes to a particular topic during these discussions... 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. Resources like a migraine diary or symptom tracker are worth the few minutes required each day to complete since this information will enhance patients' conversations with their physicians."

Summary and comments:

The statistics may be new, but the fact that there's a disconnect between how doctors and patients see appointments and the conversations that take place during those appointments differently is not new. The details of this study clearly show specific areas in which patients must make specific information available to their doctors.

For our doctors to evaluate the success of our treatments, we need to be able to clearly describe both our Migraine attacks and how our medications worked for us. This is best accomplished when information is recorded during the Migraine attack or as soon after it as possible, while the details are still fresh in our mind. Details are important.

You don't have to wait for someone to develop the tools to help you get more from your appointments with your doctor. We have those tools for you now:

  • Your Migraine and Headache Diary This article talks about the importance of a diary and some of the ways to keep one. At the end of the article, there's a link to download a free diary workbook. It contains a diary in different formats so you can choose the one that works best for you, or you can use them all.
  • Migraines and Medications This article talks about using Migraine medications safely, AND there's a link near the end of the article for you to download a free medications workbook.
  • Migraineur's Guide to a Successful Doctor's Appointment This is a good article to review and print to refer to again later. Whether you're preparing for a first visit with a new doctor, or a follow-up visit with your regular doctor, there are some tips here to help you get organized and get the most from your appointment.

One of the most important elements for keeping a Migraine diary that's really useful is to record details while they're fresh. Filling out diary forms may not be in the cards when you have a Migraine. That's fine. Just get the details on your diary before you forget any of them. Sometimes, the easiest way to do that is to keep a notepad with your medications. That way, you can make notes about how you're feeling, what medications you take, the times you take them, how they worked, and other details while the Migraine is happening. Then, you can neatly transfer them to your diary form later.

We need these appointments, and we need them to be productive. Let's see what we can do to correct the discrepancies between how we view our appointments and how doctors view them. We have the tools. Let's add some organization and make it work.


Resources:

Press Release: "New Survey Finds Gap in Doctor-Patient Migraine Communication." Chicago, Illinois, and Research Triangle Park, North Carolina. National Headache Foundation and GlaxoSmithKline. March, 2011.

Medical review by John Claude Krusz, PhD, MD

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