05/03/2011

Survey Shows Gap in Communication Between Migraineurs and Doctors

Most Migraineurs understand the time constraints doctors have in today’s medical environment. Because of these time limitations, patients must be completely prepared to talk about their concerns, provide any new and/or different symptoms to the doctor, and have a current copy of their medications ready to discuss. Some of us work diligently between appointments and keep a Migraine diary (or calendar) so we can communicate our needs accurately and efficiently during these visits. It's vital to keep an open dialog with our doctors so we can have the most effective Migraine management plan available. But a recent survey by the National Headache Foundation (NHF) and GlaxoSmithKline (GSK) concluded that there is a large gap in communication between patients and doctors.

Patients do seem to be having some dialog with their doctors, yet they aren't able to convey their needs accurately. Doctors seem to misinterpret what is truly important to patients and/or miss the focus of the appointment. In hopes of making communication better between the two, GSK will soon be launching a new online tool that may be able to improve comminucation between Migraineurs and doctors. To get a glimpse of this online tool, take a look atwww.lowerthepain.com for more information.

Harris Interactive conducted a survey in November 2010 on behalf of the NHF and GSK. I recently had an opportunity to discuss these results and how important it is for Migraineurs to be prepared for doctor’s appointments with Dr. Merle Diamond, President and Managing Director of the Diamond Headache Clinic. The results were a bit stunning; patients and physicians have some significant disparities in communication during appointments. Dr. Diamond finds this very telling and suggests more needs to be done to open conversations between Migraineurs and physicians, especially in today’s busy medical setting.

A group of 1,218 people diagnosed with Migraine disease (currently taking prescription medications for Migraine) and 533 physicians (primary care physicians and neurologists) who see between five and 10 Migraine patients per week participated in this survey.  The Migraineurs were chosen by chance from the Chronic Illness Panel contained in the Harris Poll Online database. Patients did not receive any cash, but did gather points for participating in this poll. Doctors were chosen from the American Medical Association’s Masterfile and were compensated as is standard for similar market research endeavors.

Patients in this online survey visited their primary Migraine doctor around six times a year, although almost three-quarters of these visits were devoted to other health conditions. Close to two-thirds of Migraineurs said they talked about their Migraine attacks with their doctor at these visits, but they weren’t the major topic of discussion. Patients also said the most important topic discussed was medication refills, while doctors on the other hand, said the most important issue was Migraine frequency. Other communication gaps in the survey include:

• Only 18% of patients talked about the timing of medication to treat a Migraine attack with their doctors, while close to 78% of doctors reported the same thing. 
•  38% of patients said they discussed personal triggers with their doctors, yet more that 80% of doctor’s report talking about this to their patients. 
• Fewer than 18 % of patients said they had discussed the accurate use of over-the-counter medication with their doctors, while 67% of doctors said they talked about this topic during the visit.
• 31% of patients said their acute Migraine medication is discussed during each visit, while almost 50% of doctors perceive they discuss the acute Migraine medication issue at each visit.
• 67% of doctors feel patients medications are working correctly unless a patient says otherwise.
• 69% of doctors only talk about other medication options when their patients protest about their current regime.  
• Over 35% of doctors find it difficult to assess the effectiveness of their patient’s first line acute medication and70% felt it was due to patients’ failure to remember how their medications work.     
• 50% of doctors commented on the lack of patient’s ability to describe their Migraine attack as another reason it is difficult to assess the patients medication effectiveness.

Other salient points are that patients and doctors alike (41% and 61% respectively) feel more time is needed during these visits to address questions regarding their medication regime and whether or not patients are satisfied with their treatment.  Over 90% of doctors reported that additional tools like an online Migraine diary, medication tracker and/or a symptom checker would be very helpful toward starting a dialog between patients and doctors in hopes of better communication.  In addition,  70% of Migraineurs felt the same way - online tools would be extremely helpful.

Dr. Diamond says the most valuable tool a patient and doctor can utilize is a Migraine calendar/diary. She said this helps doctors “focus in” on certain aspects of a patients Migraine management plan, possibly uncovering certain things that may have been missed before. For example, while reviewing one patient’s calendar, Dr. Diamond noticed there was little mention of caffeine on it. After some gentle probing, she uncovered that more caffeine was being consumed each day than the patient realized. This was adversely affecting the patient, and some adjustments were made to the patients Migraine regime. It is crucial to go over a Migraine diary with your doctor at each visit to see if any new patterns are emerging, or to verify if older, troublesome patterns are being kept under control.  

I’ve heard more than a few Migraineurs groan when asked if they keep a Migraine diary, me included. But it is truly an easy task to do. I kept a diary for my son when he was younger at one point, for me. The results were very interesting. Chocolate, dehydration, and poor sleeping habits will trigger a Migraine for my son. Skipping meals, dehydration, changes in the barometric pressure and certain smells will trigger a Migraine for me. Writing down everything for three months was very effective in finding out some of my Migraine triggers. If this new online tool from GSK is easy to use, practical and helps stimulate more open, effective and meaningful conversation between doctors and patients, it would go a long way to help close the communication gap between the two. 

If you'd like more information on a Migraine diary, you can download one here, Migraine Diary, to have an idea of what they are all about.

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Sources:

Interview. Dr. Merle Diamond with Nancy Harris Bonk, April 28, 2011.

National Headache Foundation and GlaxoSmithKline. "What Migraine Patients and Physicians are Saying About Prescription Migraine Treatments". Fact sheet. May 3, 2011.

GlaxoSmithKline. April 21, 2011. "New survey finds gap in doctor-patient migraine communication." Press Release. Retrieved May 2, 2011.

Thanks for reading and feel well,

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© Nancy Harris Bonk, 2011.Last updated May 3, 2011.