13 August 2018

Non-drug migraine treatments often ignored

In a study of 53 migraine patients who were referred for behavioural treatment, only 57% made an appointment.

Many migraine sufferers skip recommended behavioural treatments, such as stress management and talk therapy, a new study, published in the journal Pain Medicine, finds.

Lack of time, cost and scepticism are among the reasons why, said Dr Mia Minen, director of research for NYU Langone's headache division in New York City.

Previous studies have shown that treatments such as cognitive behavioural therapy, stress management, relaxation techniques and biofeedback may reduce migraine symptoms by 50% or more, Dr Minen and her team said. (Biofeedback involves using a monitoring device to reduce muscle tension.)

These treatments can cost less than medications and have long-term benefits for migraine reduction, the researchers noted.

More patients need to sign up 

"Migraines can be debilitating, so it stands to reason that many patients would want to access a treatment that reduces symptoms by half. However, our research shows this is far from the case," Dr Minen said in an NYU news release.

Migraine headaches affect about 36 million Americans. The moderate to severe throbbing headaches are often accompanied by nausea and/or vomiting, and sensitivity to light and sound.

For the study, Dr Minen and her colleagues looked at 53 migraine patients who were referred for behavioural treatment with a specially trained therapist. The patients were interviewed within three months of their initial appointment.

Only 30 (57%) made an appointment for behavioural treatment. Patients who had previously seen a psychologist were more likely to begin therapy. Age, gender, years of suffering from migraines and overall use of health care services made no difference, the findings showed.

Of those who did not begin therapy, half cited lack of time. Others mentioned cost (some insurance plans don't cover such treatment), doubts about its effectiveness, satisfaction with current treatment, and improvement in migraines, according to the report.

Further research is needed to find ways to convince more migraine patients to sign up for behavioural therapy, the study authors said.

"As providers, we need to develop new ways to present evidence-based behavioural treatments to patients in a similar manner in which drug therapies are presented," Dr Minen said.

Image credit: iStock


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Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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