Half of Patients Referred for Behavioral Treatment of Migraine Never Initiate Treatment

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depressed African American
Approximately half of patients who were referred for behavioral treatment for migraine were found to initiate treatment.

Approximately half of patients who were referred for behavioral treatment for migraine were found to initiate treatment, according to a study published in Pain Medicine. Time constraints were cited as being the most common barrier in these patients.

This prospective cohort study included 234 eligible individuals, 69 of whom were referred by a specialist for treatment. Of these, 53 were contacted by phone and included in the study. The mean follow-up period after referral was 76±45 days, at which point 30 participants (56.6%) had begun behavioral treatment for migraine. Treatment initiation was not found to be associated with age, number of years with headaches, Migraine Disability Assessment Screen, sex, age at time of diagnosis, healthcare utilizations visits, or locus of control (P >.05 for all). Individuals who had consulted a psychologist in the past for migraine were more likely to begin behavioral treatment for migraine compared with patients who had not. The most common reason reported for not initiating treatment was time constraints.

The primary outcome of this study was arranging a first visit to a migraine treatment facility. The investigators used variance and χ2tests to compare the characteristics of those who took this step with those who did not. Variables included demographics, locus of control, and characteristics of migraine.

“[Less] than one-third of eligible patients were referred for behavioral treatment, and only about half initiated behavioral migraine treatment. Future research should further assess patients’ decisions regarding behavioral treatment initiation and methods for behavioral treatment delivery to overcome barriers to initiating behavioral migraine treatment,” concluded the study authors.

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Minen MT, Azarchi S, Sobolev R, et al. Factors related to migraine patients’ decisions to initiate behavioral migraine treatment following a headache specialist’s recommendation: A prospective observational study [published online June 5, 2018]. Pain Med. doi: 10.1093/pm/pny028