The disability burden created created by them has caused the World Health Organization (WHO) to state that Migraine and other headache disorders, "should be classified amongst major public health disorders." A 2004 WHO report states, "in representative samples of the general populations of the United States of America and the United Kingdom, only half of those identified with migraine had seen a doctor for headache-related reasons in the previous 12 months, and only two-thirds had been correctly diagnosed." That same report also states, "The key in most areas of the world is education."
One of the primary goals established by the WHO is better physician education. Physicians who are well educated in this field often emphasize the importance of educating Migraine patients as well. The results of a study recently published in Headache show the impact of Migraine patient education.
The objective of the study was to determine if adding patient education to standard medical management of Migraine improved the clinical status of Migraineurs and reduced their need for health care such as doctor's appointments. The authors noted that such education is difficult to accomplish in the busy office setting.
The authors write, "By virtue of its prevalence, economic costs, and the suffering it inflicts, migraine represents a chronic public health crisis. Given that many of those afflicted persistently fail to avail themselves of our healthcare system and that a discouragingly high proportion of those who do receive an inaccurate diagnosis, it is particularly important that Migraineurs who present to medical attention and are correctly diagnosed receive the education and support that will enable them to utilize effectively the therapies available"
- 100 consecutive Migraine patients coming to a university headache clinic were randomized to receive or not receive a standard course of instruction on Migraine physiology and management.
- The course was three classes taught by other Migraineurs who had completed intensive training.
- All patients were evaluated at the beginning of the study and at one-, three-, and six-month points. The neurologist evaluating the patients did not know which patients were participating in the educational program.
After six months, the "school" group who participated in the educational program...
- scored significantly lower on the MIDAS disability test.
- experienced a significant reduction in the number of Migraine days per month.
- experienced a significant reduction in days incapacitated by Migraine.
- exhibited no analgesic overuse as opposed to 36% of the "no school" group.
- used abortive therapies such as triptans 1/3 as frequently as the "no school" group.
- demonstrated 96% compliance with preventive regimens as opposed to 58.5% in the "no school" group.
- made 50% fewer calls to their doctors for additional appointments for Migraine than the group not receiving the education.
"Intensive education of migraine patients by trained lay instructors may convey significant benefit to those patients and reduce their utilization of healthcare resources."
The results of this study speak for themselves and clearly demonstrate the value of patient education. As the authors of the Headache article point out, such patient education in the busy office or clinic setting can be difficult. Hopefully, many doctors will take the results of this study to heart and initiate special programs to educate Migraineurs. Successful models for patient education already exist in treating other diseases, perhaps most noticeably with certified diabetes educators. Knowledge is power. In the case of Migraine disease, it can be the power to control this disease rather than it controlling us.
Rothrock, John Farr, Parada, Victoria A., Sims, Cheryl, Key, Kristin, Walters, Naomi S. & Zweifler, Richard M. (2006) "The Impact of Intensive Patient Education on Clinical Outcome in a Clinic-Based Migraine Population." Headache: The Journal of Head and Face Pain 46 (5), 726-731. doi: 10.1111/j.1526-4610.2006.00428.x