Perspective on Migraine Patients

Transcription

1 Perspective on Migraine Patients American Headache society Sol Cavanagh, MD Raúl Carrea Institute for Neurological Research (FLENI) Headache specialized center Buenos Aires Argentina

2 Nothing to declare. DISCLOSURES

3 MIGRAINE PERSPECTIVE Migraine is a chronic neurological condition with heterogeneous clinical presentation. It can cause a limitation of daily activities. Perspective means "look through" or "perceive. A particular way of viewing things that depends on one s experience and personality. Isthe ability to consider things in relation to one another accurately and fairly. 4 3 or 4 3

4 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 are important. 51% expected to be cure. 57% effective prevention and fast relief episodes 75% reduce frequency and intensity. EVIDENCE 150 patients completed a 10 question survey about prevention treatment at a specialized headache clinic. The most important thing were: Physisians involves them in the decision making of chossing the preventive agent. Adverse events explanation Published efficacy They don t care taking 1 or more preventive treatment if it improves efficacy weight and sedationare important. 20 patients with migraine at urban and rural general practice. 3 focus groups of 6 7 migraine patients Mayor influences in patients decisions about preventive treatment in migraine: Active or passive on decision making to iniciate prophylaxis. Assessing advantages or dissadvantages Satisfaction with current migraine treatment Relation with the physician. comunication between patients and physisians active involment of individual time to explaine adverse events treatment with higher efficacy rates.

5 OBJECTIVES Understand patients concerns about their migraine. 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. Identifying i patient s t weakness helps hl us to educate them at the consult and improve their migraine.

6 METHODS 12 question survey was administered to 100 migraine patients. Age years

7 Relevance/concerns How much relevance the doctor gave to headache, if they commissioned. i What is the most important concern about migraine (Health risklimitation of activities mood changes medication) Environment comprehension Diagnosis They understand the diagnosis? Number of consults Abnormal MRI? Life Habits and life quality Impairs quality of life Life Habits influence their migraine Headache diary relevance Treatment At the migraine attack if they wait ornot for taking the pill How they feel taking preventative medication If they know about medication overuse headache (MOH)

8 Evidence on survey questions Concerns Lifestyle and Life Quality Diagnosis Treatment

9 44% Patients reported that their inquiry has not been valued by other doctors specialties RESULTS S Relevance/concerns What is the most important concern about migraine? 67% Environment comprehension Daily activities 17% limitation 17% 35% Mood change 21% Health Risk 27% Medication

10 Diagnosis 97.3% understood the diagnosis. Consults numbers: Mean % preferred an abnormal brain MRI as an explanation. This means that they do not understand their diagnosis

11 Treatment At the migraine attack if How they feel taking they wait or not for taking the pill: 31% didn t take the symptomatic medication 5% 9% immediately. 24% 62% 83% knows what medication overuse headache means. preventative medication? Feel Safe Feel Fear No answer Difficulties to accomplish treatment

12 Life Habits and life quality Impairs quality of life: 98% Life Hbit Habits influence theirmigraine: i i 61% Headache diary relevance : 83%

13 CONCLUSIONS Migraine diagnosis remains undervalued in medical practice. We 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.

14 LIMITATIONS We enrolled only 100 patients Selection bias

15 Thanks Acknowledgements Maria Teresa Goicochea Mariateresa Gutierrez Fleni Pain section Funding: Raul Carrea Neurological Research Institute (Fleni), Buenos Aires, Argentina.