Dawn C. Buse|Cynthia Armand|Larry Charleston|Michael L. Reed|Kristina Fanning|Aubrey Manack Adams|Richard B. Lipton
Barriers to care in episodic and chronic migraine: Results from the Chronic Migraine Epidemiology and Outcomes Study
Albert Einstein College of Medicine|Albert Einstein College of Medicine|University of Michigan–Ann Arbor|AbbVie (United States)|Albert Einstein College of Medicine
assess rates factors associated traversing fundamental barriers good medical outcomes pharmacologic care individuals episodic migraine em chronic migraine cm including socioeconomic status racebarriers good outcomes migraine include lack appropriate medical consultation failure receive accurate diagnosis offered regimen acute preventive pharmacologic treatments indicated avoiding medication overusethe chronic migraine epidemiology outcomes cameo study longitudinal internetbased survey respondents met criteria migraine consistent international classification headache disorders 3rd edition migraine disability assessment score 6 provided health insurance coverage status included analysis successfully traversing barrier care effects sociodemographic characteristics examinedamong 16789 respondents migraine 9184 547 em 7930 cm 1254 eligible current headache consultation reported 276 21877930 em 408 5121254 cm respondents among consulters 757 16552187 em 328 168512 cm accurately diagnosed among diagnosed consulters 599 9921655 em 542 91168 cm reported minimally appropriate acute preventive pharmacologic treatment among diagnosed treated consulters em group 318 315992 cm group 747 6891 met medication overuse criteria 85 6777930 em 18 231254 cm respondents traversed four barriers higher income positively associated likelihood traversing barrier blacks andor african americans higher rates consultation racial groups blacks andor african americans multiracial people higher rates acute medication overuseefforts improve care focus increasing consultation diagnosis rates improving delivery appropriate guidelinebased treatment avoidance medication overuse