MIGRAINE - IDENTIFYING AND REMOVING BARRIERS TO CARE

The high levels of pain and disability associated with undiagnosed mig raine or inadequate treatment of migraine offer a potential target for healthcare intervention. Both the individual patient and society are affected by decisions regarding which migraine sufferers are most in n eed of medical care. Pain is the most important symptom for the indivi dual patient; but disability may be the most important consequence of migraine for an increasingly cost-conscious society. These two perspec tives are the components of a migraine severity or impact measure bein g developed to define migraine sufferers most in need of care. The cri teria for developing screening programs provide a context for evaluati ng healthcare interventions for migraine. Barriers to effective care o ccur on at least three levels: many people with migraine do not consul t doctors; consulters may not receive the correct diagnosis; and even when the correct diagnosis is made, many migraineurs do not receive ef fective treatment. Screening and impact measures may help both to impr ove diagnosis and to determine which migraineurs are most in need of c are. Public and physician education, screening, and impact measures mi ght circumvent many of the barriers to effective care for people with migraine.