Abstract
Background:
Migraine headache is associated with significant costs. Many patients with migraine do not receive appropriate care. Correct diagnosis of migraine is often elusive, which may impact patient care.
Objective:
To determine the economic and disability burdens that patients with migraine experience before treatment and after diagnosis and treatment.
Methods:
This survey was administered to patients in a community pharmacy. Eligible patients were 18–40 years of age with diagnosed migraine who had prescriptions for an ergotamine, triptan, or combination product containing acetaminophen, isometheptene, and dichloralphenazone. Main outcome measures included pre- and postdiagnostic comparison of patient disability measures, migraine medication use, migraine-related patient costs, and physician office visit characteristics and diagnostic testing.
Results:
Forty-nine patients completed the study (mean ± SD age 38 ± 14 y, 90% female). The average age of symptom onset was 24 ± 13 years, with first presentation to physician at age 28 ± 12 and diagnosis made at age 31 ± 12 years. The mean number of physicians visited was 2.3 ± 4.7, comprising 5.3 ± 7.8 office visits before diagnosis. After diagnosis and treatment, significantly fewer patients experienced attacks lasting ≥16 hours and reported missing ≥5 days of work/month from migraine symptoms. Patients also reported significantly increased effectiveness at work when experiencing symptoms after diagnosis and treatment.
Conclusions:
This study demonstrated that migraine often eludes formal diagnosis and diagnosis is difficult for the primary care physician to make without expensive tests and/or consultation. Patient outcomes were greatly improved after a formal diagnosis followed by appropriate treatment.
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