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Cited by 261

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Information About Migraine Disability Influences Physicians' Perceptions of Illness Severity and Treatment Needs

Holmes, William F., MacGregor, E. Anne, Sawyer, James P.C., Lipton, Richard B.·2001·Headache: The Journal of Head and Face Pain
DOI 10.1046/j.1526-4610.2001.111006343.x
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Abstract

Objective.—To assess physician‐patient communication about headache‐related disability and to evaluate the influence of information about disability on physicians' perceptions of illness severity and the treatment needs of migraineurs. Background.—Evidence suggests that migraine is suboptimally treated in clinical practice, partly due to poor communication between physicians and their patients. Methods.—One hundred five neurologists and primary care physicians with an interest in headache participated in two interactive surveys, one in North America (n = 42) and one in Europe (n = 63). Each survey focused on the evaluation of four videotaped migraine cases. The first case was evaluated twice, initially after a typical symptom history that centered on diagnosis and then following a fuller history of migraine disability. Additional questions assessed the extent of the collection of migraine disability information in clinical practice. Results.—Physicians reported that they recorded symptoms relating to diagnosis (eg, pain location/intensity, associated symptoms) rather than information on headache‐related disability. Only about one third of patients volunteered disability information. When made available to them, physicians rated information on disability as one of the most important factors in assessing treatment needs. In particular, when physicians knew the patient's disability history: (1) the proportion of physicians who rated the patient's illness as “severe” increased by 128% in North America, 27% in Europe; (2) the proportion of physicians who recommended immediate treatment increased by 63% in North America, 37% in Europe; and (3) the proportion of patients recommended for a follow‐up visit increased by 15% in North America, 18% in Europe. Conclusions.—Physicians and patients often fail to discuss headache‐related disability during consultation. This information has a powerful influence on physicians' perceptions of illness severity, treatment choice, and the need for follow‐up. Tools to improve communication about headache‐related disability, such as the Migraine Disability Assessment questionnaire, may favorably improve migraine management.

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Research works printed but not linked: 12

  1. Stewart WF, 1994, Migraine heterogeneity. Disability, pain intensity, and attack frequency and duration., Neurology, 44, S24
  2. 10.1046/j.1468-1331.1998.560525.x · DOI
  3. 10.2165/00019053-199813060-00003 · DOI
  4. 10.1001/archinte.159.8.813 · DOI · Paper page
  5. 10.1046/j.1526-4610.1998.3802087.x · DOI · Paper page
  6. Lipton RB, 1999, Patterns of healthcare utilization for migraine in England., Cephalalgia, 19, 305
  7. Lipton RB, 1994, Migraine: identifying and removing barriers to care., Neurology, 44, S63
  8. Sawyer JP, 1998, Clinical utility of a new instrument assessing migraine disability: the Migraine Disability Assessment (MIDAS) Questionnaire [abstract]., Neurology, 50, A433
  9. Lipton RB, 2000, Stratified care is a more effective migraine treatment strategy than stepped care: results of a randomized clinical trial [abstract]., Neurology, 54, A14
  10. 10.1046/j.1468-2982.1999.019002107.x · DOI · Paper page
  11. 10.1212/WNL.53.5.988 · DOI · Paper page
  12. Stewart WF, 1999, Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary based measure in a population sample of migraine sufferers [abstract]., Neurology, 52, A470

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Metadata

Authors
Holmes, W. F., MacGregor, E. A., Sawyer, J. P. C., & Lipton, R. B.
Venue
Headache: The Journal of Head and Face Pain
Publisher
Wiley
Published
2001-04-04
Volume
41
Issue
4
Pages
343-350
ISSN
  • 0017-8748 (ISSN-L)
  • 1526-4610
DOI
10.1046/j.1526-4610.2001.111006343.x
OpenAlex
W2122171015
Cited by
261
References
0
FWCI
4.46
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 260 d)

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