Headache in the UK : are things better than in Canada?
A recent survey done in British Headache Clinics reveals interesting facts.
- Only 1/3 of patients had received a clear diagnosis from their primary care doctor.
- Up to 2/3 of patients wanted a brain scan to find the cause of their headaches.
- Less than 15% were aware of headache charities in the UK where they could find support.
- Depending on the clinic, patients reported between 7 and 44 days lost to migraine over the last year.
- Patients had spent (estimate) between 350 and 2000 GBP for their headache with for different treatments and health advices.
In conclusion, it seems that the very first step to improve migraine care could be a proper diagnosis by a family physician.
This should be followed by a clear explanation of what migraine is, why it is not seen on a brain CT and what prognosis can be expected. Then, guidance about a global management plan should be offered to the person. This plan should include tips about lifestyle, headache diary, information on medication overuse headache, acute and preventive treatments. This may vary significantly from one person to the other.
One may wonder WHY family practitioners struggle to diagnose migraine (and other headaches) confidently? Well, picture this. Guesstimates from my conversations with colleagues suggests that the number of hours spent on headache education during the Family Medicine residency is…..2 hours. If that is true, no wonder that our GP colleagues find it difficult to manage migraine.
Now, HOW can we help? Migraine Canada will soon be an official organization. Our goal is to represent headache and migraine sufferers. One very concrete action could be taken: getting the real data on how Family Practitioners are trained to diagnose and manage headaches. And if, as we suspect, the training is insufficient, partner with the Canadian Headache Society to improve it. For example, we could advocate for more hours, a template curriculum, slide kits and training courses. Expert patients could even participate by sharing their experiences on the migraine path with young physicians.
Does that sound like a plan? If yes, please like us and share the word! Migraine Canada wants to evolve according to real people’s needs. Let us know what you think!
Dr Elizabeth Leroux
Reference: The long and winding road: the journey taken by headache sufferers in search of help.Davies PTG et Al, Prim Health Care Res Dev. 2018 May 31:1-6 PMID: 29848391