Migraine diagnosis key to finding relief; emergency room often not the answer

Migraines sufferers want relief fast. The debilitating effects of a migraine can seriously impair quality of life, disrupting work and family time. If patients have been properly diagnosed by their primary care physicians, they probably have appropriate medication on hand. If not, they may head to the nearest hospital emergency room and that could become a problem.

Jackie Kwong, assistant professor at the University of Georgia College of Pharmacy, has undertaken a study that looks at the continuity of care for migraine patients following these emergency room visits.

"Headache is the sixth most common reason for going to an emergency room," Kwong said. "Of the 28 million people in this country who suffer from migraines, fewer than 50 percent have been diagnosed by a physician. Many sufferers try to treat their migraines with ineffective over-the-counter products

"The economic impact of patients going to emergency rooms for this non-emergency condition is tremendous. Physicians there are trained to treat life-threatening conditions and may not be skilled in diagnosing migraines or in providing proper medication," Kwong said. "Furthermore any recommendation for follow up care with a primary care physician might be ignored by the patient after the migraine has ended

Kwong noted that many good medications for migraines, such as

the answer

triptanes, have become available in the last 10 years, but emergency room physicians occasionally misdiagnose the condition and instead prescribe barbiturates or narcotics for the pain. When the next migraine occurs, the patient still would not have the proper medication and may go back to the emergency room.

"Studies of follow-up screenings of these migraine sufferers have shown that only 30 percent of headache patients going to emergency rooms are correctly diagnosed as migraine sufferers, even though symptoms may indicate that diagnosis," Kwong said.

With funding from the Pharmaceutical Researchers and Manufacturers of American (PHARMA) Foundation

and the UGA Research Foundation, Kwong will be analyzing data on Georgia Medicaid patients who visit emergency rooms for headaches.

"This is a good population to study for several reasons. The patients tend to be low-income and therefore may be without a primary care physician," she said. "Many are also single mothers, and migraines tend to be hormone-related, occurring most frequently in women between the ages of 25 and 40.

"If we have evidence that followup care can reduce health care costs, then we'll be able to develop intervention programs to facilitate patients receiving the care they need in an emergency room setting, " said Kwong, who had nine years experience of studying migraine outcomes research with Glaxo SmithKline prior to coming to UGA.