Improving Quality of Life for Migraineurs

One of the unmet needs of the migraine population is the identification of individuals who actively require treatment. When migraine is left untreated or inadequately treated, increased medical costs and decreased productivity result. Of the roughly 25 to 30 million Americans with active migraine, around 6 million have the chronic variant, meaning they have suffered headaches at least 15 days per month for at least 3 consecutive months. Chronic migraine accounts for a disproportionate share of the economic burden associated with migraine generally. Prevention or suppression of headaches associated with chronic migraine assumes paramount importance. It can be challenging for physicians to choose the most appropriate therapy for treating migraine, and there are many issues to consider when determining the most appropriate management strategies. Clinicians must ask themselves if their patients are in need of acute therapy only or prophylactic therapy in addition to acute therapy. Although guidelines are available to assist clinicians in prescribing prophylactic therapy, treatment needs and responses vary from patient to patient. Arriving at an effective treatment regimen may take time, and patients should be warned not to expect instant success. A commitment from patients to adhere to prescribed treatment strategies typically will be required to achieve a successful outcome. Open communication between providers and patients and the provision of educational materials are essential to fostering positive outcomes. Ensuring Adherence The importance of patient education cannot be overestimated. My colleagues and I have conducted studies in which migraineurs attended a headache school taught by lay instructors. Patients who received this type of education—which focused on the biology of migraine as well as acute and chronic...