Migraine and Migraines of Specialists: Perceptions and Management

Authors

  • Anne Donnet MD,

    1. From the Neurology Department, Hôpital la Timone, Marseille, France (A. Donnet); Les Anémones Medical Centre, Cannes, France (H. Becker); Almirall SAS, Paris, France (B. Allaf); INSERM U929, Department of Evaluation and Treatment of Pain, Clinical Neurosciences Pole, Hôpital Pasteur, Nice, France (M. Lantéri-Minet).
    Search for more papers by this author
  • Henri Becker MD,

    1. From the Neurology Department, Hôpital la Timone, Marseille, France (A. Donnet); Les Anémones Medical Centre, Cannes, France (H. Becker); Almirall SAS, Paris, France (B. Allaf); INSERM U929, Department of Evaluation and Treatment of Pain, Clinical Neurosciences Pole, Hôpital Pasteur, Nice, France (M. Lantéri-Minet).
    Search for more papers by this author
  • Bashar Allaf MD,

    1. From the Neurology Department, Hôpital la Timone, Marseille, France (A. Donnet); Les Anémones Medical Centre, Cannes, France (H. Becker); Almirall SAS, Paris, France (B. Allaf); INSERM U929, Department of Evaluation and Treatment of Pain, Clinical Neurosciences Pole, Hôpital Pasteur, Nice, France (M. Lantéri-Minet).
    Search for more papers by this author
  • Michel Lantéri-Minet MD

    1. From the Neurology Department, Hôpital la Timone, Marseille, France (A. Donnet); Les Anémones Medical Centre, Cannes, France (H. Becker); Almirall SAS, Paris, France (B. Allaf); INSERM U929, Department of Evaluation and Treatment of Pain, Clinical Neurosciences Pole, Hôpital Pasteur, Nice, France (M. Lantéri-Minet).
    Search for more papers by this author

  • Financial support: This study was supported by Almirall SAS, Paris, France.

  • Conflict of Interest: BA is an employee of the Almirall SAS, a company that manufactures almotriptan, a migraine treatment. MLM has perceived personal compensation for activities (consulting, clinical research) with Allergan, Almirall SAS, AstraZeenca Pharmaceuticals, Glaxo-Smith Kline Inc, Grunenthal, Eli Lilly & Company, Johnson & Johnson, Medtronic, Menarini, Merck, Pierre Fabre, Pfizer Inc, Sanofi-Aventis, UCB, Zambon. AD has perceived personal compensation for activities (consulting, clinical research) with Almirall SAS, AstraZeenca Pharmaceuticals, Glaxo-Smith Kline Inc, Merck, Pierre Fabre, Pfizer Inc.

A. Donnet, Service de neurologie, Hôpital de la Timone, 264 boulevard Saint-Pierre, 13385 Marseille Cedex 05, France.

Abstract

(Headache 2010;50:1115-1125)

Objectives.— To describe the perception of migraine by neurologists in France, to compare perceptions between neurologists who did and did not suffer from migraines and to describe treatments used for their own migraines.

Background.— Patients with migraine are usually undertreated, as treatment guidelines are frequently not followed and, therefore, resulting treatment satisfaction is low. One reason for this may be inappropriate perceptions of physicians concerning the seriousness of the pathology and the need to treat. However, available information on physician perceptions of migraine is limited.

Methods.— This was an observational, epidemiological survey conducted both in hospital- and community-based neurologists in France. Participating neurologists completed an anonymous questionnaire which collected data on demographics, migraine status, and perceptions of migraine. Neurologists who considered themselves migraineurs also provided data on migraine impact, treatment and on treatment satisfaction. Distributions of responses to questions on migraine perceptions were compared between migraineur and nonmigraineur neurologists.

Results.— The study included 368 neurologists, of whom 179 (48.6%) were migraineurs themselves. Some 92.3% of participants claimed to be very or quite interested in migraine. Migraine was considered a real illness by 96.5% of neurologists and to be very or quite disabling by 96.6%. Around half perceived migraine as a challenging condition to manage with respect to unrealistic patient expectations (46.2%), time-consuming treatment (48.9%), and complications because of anxious or depressive comorbidity (59.9%) or medical nomadism (consulting multiple physicians for the same condition; 47.0%). No significant differences in any perception items were observed between migraineur and nonmigraineur neurologists. In total, 83.1% of neurologists were satisfied with acute headache treatments and 60.4% with prophylactic headache treatments. The most frequently reported treatments for neurologist's own migraines were nonsteroidal anti-inflammatory drugs (used by 57.0%) and triptans (50.3%).

Conclusions.— French neurologists are interested and concerned about migraine but find it challenging to treat. Migraine perceptions do not differ between neurologists who do and do not suffer from migraines themselves. Neurology training needs to prepare medical students adequately for the challenges of migraine treatment in terms of patient communication and psychiatric issues.

Ancillary