This is ReachMD. Welcome to this special series, Rethinking Migraine, sponsored by Lilly.
On this episode, titled "Migraines and your patients' lives", we will hear from Dr. Stephanie Nahas, the Director of the Headache Medicine Fellowship Program at the Jefferson Headache Center in Philadelphia.
It's really important to assess the impact migraine has on a particular patient, first and foremost. This is something that most doctors don't bother to do, because migraine is an invisible illness and patients often don't even want to bring it up in the first place. Patients with migraine feel isolated, even ashamed, because of the stigma associated with it, and the fact that it's even come up in the office visit is big. So take the opportunity to take the patient seriously and to ask them not just about the characteristics and quality of the headache to get to a diagnosis, but also the serious impact and effects it's having on them, on their family, on their loved ones, their coworkers, their employer. Really every aspect of their lives is affected by migraine. So assessing this impact is very important.
Another important thing to ask patients is not just when they're having an attack, how much functional incapacity it causes, but in between attacks; because many patients, even outside of an attack, when they're feeling well, are living in fear of when the next one is going to occur. And so this is a reason it's important to assess for that aspect of migraine burden. Migraine is something that's going to affect that person 24/7, not just when they're having an attack.
There are tools available to assess the disability and impact associated with migraine. Just a couple that spring to mind are the MIDAS, the Migraine Disability Assessment Scale, and the HIT-6 which is the Headache Impact Test. These are validated measures of migraine disability, but they're not always necessary in every encounter; just being familiar with the language to discuss this problem with your patient and make it real for them, to validate their concerns that migraine is a disabling disease. Important points in assessing the impact and disability of migraine are: Number 1) validation that this is a real disease that affects that individual, not just when they're having an attack, but also in between attacks.
Number 2) getting a sense of how often migraine is affecting that person and why. Is it the pain? Is it the associated symptoms? Is it the medications that they're using to treat the attacks, which have side effects? And number 3) how is migraine affecting, not just them, but everyone around them and everything that they care about? Their loved ones, their coworkers, their employers, the things that they like to do for recreation and for enjoyment. So taking all of this into account really gets at the whole person suffering with the disease of migraine.
The preceding program was sponsored by Lilly. To revisit any part of this discussion and to access other episodes in this series, visit ReachMD.com/rethinkingmigraine. Thank you for listening.
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Rheumatoid Arthritis: Addressing Unmet Needs is sponsored by Lilly. Content for this a non-certified educational series is produced and controlled by ReachMD. This series is intended for healthcare professionals only.