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Barriers to Satisfactory Migraine Outcomes. What Have We Learned, Where Do We Stand?
Author(s) -
Bigal Marcelo,
Krymchantowski Abouch Valenty,
Lipton Richard B.
Publication year - 2009
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2009.01410.x
Subject(s) - migraine , psychology , psychiatry
Barriers to optimal migraine care have traditionally been divided into a number of categories: under‐recognition and underconsultation by migraine sufferers; underdiagnosis and undertreatment by health care professionals; lack of follow‐up and treatment optimization. These “traditional” barriers have been recognized and addressed for at least 15 years. Epidemiologic studies suggest that consultation, diagnosis, and treatment rates for migraine have improved although many migraine sufferers still do not get optimal treatment. Herein, we revisit the problem, review areas of progress, and expand the discussion of barriers to migraine care. We hypothesize that the subjective nature of pain and difficulty in communicating it contributes to clinical and societal barriers to care. We then revisit some of the traditional barriers to care, contrasting rates of recognition, diagnosis, and treatment over the past 15 years. We follow by addressing new barriers to migraine care that have emerged as a function of the knowledge gained in this process.