Lack of Treatment Could Be Main Cause of Sporadic and Chronic Migraines, Study Says

Less than one in every three people with migraines use guideline-recommended prescription medication. This information was presented during the yearly scientific meeting at the American Headache Society.

Based on results from an online survey via the OVERCOME study, about 28 percent of the respondents who encounter severe migraine-related conditions took medicine to treat acute migraines. 

Sponsored by Eli Lilly, OVERCOME is an online survey developed to follow population samples that have migraines in the United States for two consecutive years. 

Relatively, about 15 percent of the respondents who had four or more days of migraine attacks and "moderate to severe migraine-related" illnesses received preventive treatment. This is according to a report from Susan Hutchinson, MD from the Orange County Migraine and Headache Center in California, and Sait Ashina, MD, from Israel Deaconess Medical Center in Boston.

Geisel School of Medicine's Stewart Tepper, MD, on the other hand, said, the results are not surprising. Even among individuals who suffered from the most severe disability due to migraines. Tepper, who was not part of the study explained, two-thirds of them did not undergo treatment.

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Combats with Payers and Education as Parts of the Problem

Tepper also explained that one of the problems could possibly be education. He added, "We've been attempting since the 90s" to teach providers how the diagnosis of a migraine is made.

Nevertheless, he said, fights with payers play a role, as well. It is quite disheartening, and he elaborated that there is a need for providers to "jump through hoops" and even then, many medicines are not included.

OVERCOME studied a "nationwide representative sample" of over 20,000 individuals with sporadic and long-lasting migraine who completed the online survey in 2018.

Previous surveys of treatment obstacles were made in healthcare settings. Ashina said OVERCOME provides a different observation, and that is a modern view of the healthcare landscape linked to migraines.

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3-Step Migraine Management 

During the conduct of the online study, the questionnaire distributed to respondents asked about the three-step migraine management. These steps included asking for care, getting a diagnosis, and being given recommendations about the medicines to take.

Specifically, the said survey identified the suggested medications as those with reputable or feasible efficiency based on the 2012 American Academy of Neurology guidelines and the AHS position statement in 2018, on new treatments for migraine.

In an analysis explicitly conducted about acute migraines, "63 percent of respondents sought care." More so, about 47.5 percent were diagnosed, while those who received treatment comprised of only 27.9 percent of the respondents.

Meanwhile, in the analysis, specifically in terms of prevention, 69 percent of the respondents sought care, while 54.8 percent were diagnosed, another 15.4 percent of the respondents, according to the online study, took preventive medications.

Essentially, having health insurance, as well as a high level of disability related to the migraine amplified the probability of seeking care, undergoing diagnosis, and receiving treatment.

In both groups, roughly 10 percent of survey participants, according to Ashina, "sought care in an emergency department or urgent care facility," making it possible for them to receive the correct diagnosis and recommended cure.

The first group of over 21,000 patients with migraines began to sign up in 2018. The second wave of more than 20,000 enrolled late last year.

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