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June is Migraine & Headache Awareness Month. Activities are held to increase the public’s knowledge of headaches and migraines, eliminate prejudice, and spread awareness about the disease (including the awareness that migraines are a neurological disease).
In conjunction with this month’s activities, CareNet surveyed 207 of its member physicians (101 headache treatment specialists, 106 clinics, and other non-specialists), who are mainly involved in migraine treatment.
- The most common reasons for patients with migraine’ first visit to a medical facility were “because the pain has been interfering with work and daily life” (specialists:37.2%) and “because existing or over-the-counter medications are no longer effective” (non-specialists:34.5%). We found that many patients with migraine tend to “tolerate the pain” under normal circumstances and only visit a medical institution when the pain becomes unbearable.
- In the “reasons why patients come to see a doctor after their migraine has become severe,” the most common reason given by both specialists and non-specialists was “because the pain has become unbearable, although it had been treated with over-the-counter medications before. However, about three times as many non-specialists as specialists cited “because the patient did not know that migraine was a target for treatment and had put up with/given up on the pain for a long time,” suggesting that many patients are still unaware that migraine is a neurological disorder that needs to be treated.
- The average of each answer for “assuming there are 100 patients with migraine” was calculated, and the results showed that for “the percentage of patients who receive triptans,” 61% of specialists and 38% of non-specialists prescribed triptans, which is the standard treatment for severe headaches, and that the percentage of non-specialists who prescribed triptans was low.
When asked, “What are the most common reasons for patients with migraine’ first visit to a doctor?” The most common reason specialists gave (37.2%) was “because the pain has been interfering with work and daily life,” while the most common reason non-specialists gave (34.5%) was “because existing or over-the-counter medications are no longer effective.” In both cases, it was found that patients with migraine tend to “tolerate the pain in daily life with over-the-counter medicines,” but only visit a medical institution when the pain exceeds the limit.
However, while there were not many responses from non-specialists, the most common response from specialists was “concerned about other diseases in the brain/wanting a brain scan” at 12.8% (5.7% for non-specialists). Conversely, the more common response from non-specialists was “because the pain has become worse (unbearable, nausea, etc.)/ prolonged pain” at 25.3% (16.0% for specialists). The latter, particularly, suggests that patients visit a nearby clinic as an emergency measure because they can no longer bear the pain.
［Table1］
When asked, “Regarding patients who come to see you after their migraines become severe, why do you think they came to see you after their migraines became worse?” The most common answer was “because the pain became unbearable, although they had been treated with over-the-counter medications” (66.0% of specialists and 51.7% of non-specialists).
However, 27.6% of non-specialists cited “because the patient did not know that migraine was a target for treatment and had put up with/given up on the pain for a long time,” almost three times as many as 9.6% of specialists. This suggests that those who do not know that migraine is treatable do not reach out to specialists and that awareness of migraine as a neurological disorder that should be treated remains low.
[Table2]
We asked three questions about 100 patients with a diagnosis of migraine (based on our experience in daily practice) and calculated the average percentage of responses. The responses to “What percentage of triptans are administered?” was 61% for specialists and 38% for non-specialists, indicating that even triptans, the standard treatment for severe headaches, were prescribed by a small percentage of non-specialists.
Similarly, “What percentage of your patients even implement preventive treatment?” resulted in 33% for specialists and 19% for non-specialists, with both specialists and non-specialists prescribing it less frequently.
In the question, “What percentage of patients return to see the doctor again?” was 60% for specialists and 42% for non-specialists. The results showed that, especially among specialists, patients may be encouraged to return to the doctor when they learn that treatment is available.
[Table3]
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