MEDICAL CONSULTATION FOR MIGRAINE - RESULTS FROM THE AMERICAN MIGRAINE STUDY

Background.-Migraine headaches are often disabling but usually respons ive to treatment. Nonetheless, many people with migraine never consult a doctor for headaches. In a sample of the US population, we sought t o determine the proportion of active migraineurs who ever consulted a doctor for headache and to identify the headache characteristics and s ociodemographic factors associated with consulting. Method.-A mailed q uestionnaire survey was sent to 15 000 US households, selected from a panel to be representative of the US population. Of 20 468 eligible re spondents ranging in age from 12 to 80 years, 2479 met a case definiti on for migraine. We mailed a second questionnaire to all migraineurs i dentified on the first survey and achieved a 69.4% response rate. The second survey assessed headache characteristics, patterns of medical c are use, medication use, and method of payment for health care. Result s.-Sixty-eight percent of female and 57% of male migraineurs reported having ever consulted a doctor for headache. Consultation was more lik ely with increasing age and in women who ever married. In females, sev eral headache characteristics including pain intensity, number of migr aine symptoms, attack duration, and disability were associated with co nsultation. Of those who never consult, 61% report severe or very seve re pain and 67% report severe disability or the need for bed rest with their headaches. Conclusion.-The results of this survey indicate that a significant proportion of migraine sufferers never consult doctors for their headaches. Given that a large proportion of persons who neve r consult report high levels of pain and disability, these data sugges t that there are opportunities to appropriately increase health care u tilization for migraine. Given that 40% of migraineurs who have ever c onsulted do not report a physician diagnosis of migraine, there is a n eed to improve headache diagnosis and/or doctor-patient communication about migraine.