What are patients looking for in migraine treatment? Take a look at what this study found about the importance and role of the patient’s perspective.
The process of finding the right migraine treatment must be rooted in a strong sense of trust between a person and their doctor, and patients need to know that their care provider is committed to fully understanding their unique experience with migraine. This goes beyond just a patient’s medical history and symptoms, and also should include a deeper understanding of what a person actually wants from their migraine care.
But what do people with migraine actually want and expect from their care providers? We spoke with Rashmi Halker Singh, M.D., neurologist and associate professor at Mayo Clinic Arizona, to better understand the patient’s perspective on migraine treatment. Dr. Halker Singh and her team conducted a study using previously published research to identify what patients value when discussing their migraine symptoms and treatment plan with their doctor.
The study found that patients and doctors are often not on the same page when it comes to migraine treatment. The most important discovery was that patients expressed a desire to be more involved in the treatment planning process. Read on to find out what exactly this means for the future of migraine treatment.
What Patients Look for in Migraine Treatment
To better understand what people with migraine look for when it comes to treatment planning and receiving care, the researchers identified 8 key themes across 19 previous studies:
- Shared decision making
- Management plans designed for their individual needs
- Trust in healthcare professionals
- Sharing of knowledge and variety of treatment options
- A holistic approach that does not just address headache symptoms
- Ease of communication, especially when discussing complex treatments
- Having their symptoms recognized and validated
- Mutual respect between patient and provider
“These were the things that individuals who live with migraine really valued when they were seeking care for their disease,” says Dr. Halker Singh. “I think this also reflects my perspective as a clinician who takes care of people who live with migraine as well. My patients are typically very much interested in taking an active role in making decisions about treatment.”
While pain relief and pain remission are crucial to migraine treatment, patients do not want that to be the only focus. Instead, they want to be able to trust their doctors, be taken seriously, and have a wide variety of treatments available. The key finding of the study was that patients generally want to be more involved in all aspects of the treatment planning process.
“The basis for this work was to really understand what our patients’ expectations are and how we can help meet them,” says Dr. Halker Singh. “I think that’s helpful for everyone involved.”
Prioritizing the Patient’s Voice in Migraine Treatment
Studies like this not only emphasize important patient perspectives that can help doctors and other healthcare providers better meet their patients’ needs, but they also help to validate the experiences of people living with migraine.
“So many people I know who live with migraine tell me about the isolation of migraine, feeling like they’re alone in this and nobody else understands,” says Dr. Halker Singh. This feeling of isolation that often comes along with migraine can in some cases be as debilitating as the disease itself. Actively engaging the patient in their treatment plan is not only critical to finding the right management strategies for their needs, but it also reminds them they are not alone and that there are others they can reach out to for help managing the disease.
Dr. Halker Singh and her team even had three people who have received treatment for migraine review their findings and provide feedback on the identified themes, discoveries and conclusions of the study before publication. This ensured that patient perspectives were incorporated into the study at every stage.
“We [also] wanted to check our manuscript for any personal biases or inaccuracies,” adds Dr. Halker Singh. This kind of involvement contributed to the research team’s goal of giving patients a greater voice in their care. It also helped identify additional patient concerns that hadn’t been clear in the team’s original cross-sectional research.
Increasing Education and Access to Care
One issue raised by the patients who reviewed the study was frequent difficulty in accessing care, especially in a post-pandemic era. “I think one of the difficulties… is access to care right now,” says Dr. Halker Singh. “I talk to my colleagues and people around the country—it’s just very difficult to get in to see someone at the moment.”
As a result, patients expressed a desire for a more informed approach to migraine care—one that gives them multiple options to manage their symptoms. Dr. Halker Singh and her team reported that patients want to understand more about how migraine impacts their physical and mental health and the mechanisms that cause migraine attacks.
They also found that patients prefer doctors that are more knowledgeable about non-medication treatments and alternative treatments like cognitive behavioral therapy (CBT) and nutraceuticals like vitamin supplements.
“It’s important for us as clinicians to stay on top of treatment options, and to be well-versed in what these options are so we can help guide our patients appropriately,” says Dr. Halker Singh. Informing patients about the full range of available treatment options gives people more decision-making power in their own care, and it can also have the secondary benefit of building doctor and patient trust.
The Future of Patient Involvement and Migraine Treatment
The results of this study show a promising future for patients looking for a more inclusive approach to migraine treatment. According to Dr. Halker Singh, more and more clinicians are beginning to realize the benefits of getting to know patients on a more personal level. In addition to making patients feel heard and validated, a tailored, individualized approach can help clinicians improve a patient’s chances for successful treatment.
Additionally, Dr. Halker Singh notes that this study had a limited sample pool and consisted mostly of white women in North America, with only two past studies explicitly reporting on African American and Latino populations. Future research will need to consider a larger sample size and include a more diverse range of participants.
“Culture and background can also influence a lot of this as well, and I think clinicians need to be aware of that,” says Dr. Halker Singh. “It’s important to be intentional about trying to recruit a more diverse population in trials so that we can collect more diverse opinions of individuals who live with migraine. Because as we know, migraine affects everybody.”
The patient perspective is a crucial aspect of migraine treatment. Stigma surrounding migraine not only causes patients to hesitate to share their symptoms and conditions, but it also causes some clinicians to overlook patient values and perspectives. But as more and more patients are becoming involved in their own treatment planning, doctors and researchers will also gain a better understanding of migraine and its impact.
“If we have research that helps to bring the patient’s voice to the forefront to begin with,” adds Dr. Halker Singh, “then clinicians are better informed, more prepared and likely better able to meet that patient’s expectations.”
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
