Physicians and Patients Need to Talk .... journal article

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Posted by DougW ( on August 07, 2001 at 14:45:36:

Wait...yes, this uses the "M" word, but it may help some who are having trouble getting the MD to understand the disabiling effects of headpain.

As reported in medscape, from the journal Headache:

Physicians and Patients Need to Talk About Migraine-Related Disability

WESTPORT (Reuters Health) Jul 27 - Better tools are needed to facilitate conversations between patients with migraine-related disability and their physicians, according to researchers in the UK and the US.

Dr. William F. Holmes, from Sherrington Park Medical Practice, Nottingham, UK, and colleagues conducted two identical surveys, one of 42 neurologists and primary care physicians in North America and the other of 63 similar physicians in Europe. The physicians assessed illness severity after viewing a videotaped interview with a migraineur who related a typical symptom history, then again after hearing her relate details of migraine-related disability.

In another part of the study, the physicians completed a questionnaire about headache history taking.

Physicians primarily focused on recording symptoms such as pain location and intensity rather than information on disability relating to headache, the researchers report in a recent issue of Headache. However, when information on migraine-related disability was presented to them in detail, physicians rated such disability "as one of the most important factors in assessing treatment needs," and they were inclined to pursue a more aggressive course.

The researchers note that the "proportion of physicians who rated the patient's illness as 'severe' [once they knew the disability history] increased by 128% in North America [and] 27% in Europe. The proportion of physicians recommending immediate treatment increased by 63%" in the North American group, and 37% in the European group, with followup recommendations also increasing, by 15% and 18%, respectively.

"Tools to improve communication about headache-related disability, such as the Migraine Disability Assessment questionnaire, may favorably improve migraine management," the researchers conclude.

Headache 2001;41:343-350.

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