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. 2020 Dec;9(2):551-565.
doi: 10.1007/s40120-020-00205-4. Epub 2020 Aug 7.

Management of Migraine and the Accessibility of Specialist Care: Findings from an Extended Multinational Survey (My Migraine Center Survey)

Siriporn Wongsiriroj  1 , Elisabetta Grillo  2 , Sabrina Levi  3 , Ronald Zielman  4 , Elia Lahouiri  5 , Marco Marchina  5 , Marco Pedrazzoli  5 , Matias Ferraris  6
Affiliations

Management of Migraine and the Accessibility of Specialist Care: Findings from an Extended Multinational Survey (My Migraine Center Survey)

Siriporn Wongsiriroj et al. Neurol Ther. 2020 Dec.

Abstract

Introduction: The parent study was a survey in 28 headache centers (6 countries) which identified five potential root causes for long waiting lists that limit patient access to specialist care. Here we performed an extension of the parent study to increase the panel of centers contacted, the representativeness of the analysis, and the statistical validity of the results, and to explore the role of dedicated headache clinics, triage, and specialized nurses.

Methods: We conducted a 19-question survey using a sample of 239 headache centers (16 countries). The five-area framework identified in the parent study was confirmed and further developed by describing treatment center archetypes according to their setting (general neurology versus dedicated clinic) and resources available within the center (number of healthcare professional [HCPs] full-time-equivalent positions).

Results: In total, 474 HCPs were interviewed across 16 countries. The proportion of patients with chronic migraine and episodic migraine varied across centers and countries. There was limited access to specialized centers in this enlarged sample; with global average waiting list of 3.7 months for the first visit and 2.5 months for the follow-up visit. Long waiting lists for headache patient care is a major issue in several countries, with the waiting lists for new patient visits extending up to 14 months. The presence of a dedicated nurse was correlated positively with the use of triage for prioritization of patient access (correlation coefficient: 0.85) and completing migraine diary (0.71).

Conclusion: This study confirmed differences across treatment center archetypes in terms of patients, waiting lists, level of delegation to nurse, and patient education and compliance, and provides support for the potential benefit of dedicated clinical settings for headache patients. The survey highlighted the potential role of nurses in patient education and waiting list prioritization, consequently benefiting headache centers.

Keywords: Access; Care; Clinic; Dedicated; Migraine; Nurse; Practice; Survey; Triage; Waiting lists.

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Conflict of interest statement

Siriporn Wongsiriroj is an employee of Novartis (Thailand) Limited. Elisabetta Grillo is an employee of Novartis Farma S.p.A. Sabrina Levi was an employee of Novartis Argentina S.A. at the time the study was performed. Ronald Zielman is an employee of Novartis Pharma B.V. Matias Ferraris is an employee of Novartis Pharma AG. Elia Lahouiri, Marco Marchina, and Marco Pedrazzoli are employees of LifeSciences Consultants.

Figures

Fig. 1
Fig. 1
Framework of analysis. Adapted from Kainth et al. [13]
Fig. 2
Fig. 2
Archetype identified according to setting and resources available. FTE full-time equivalent, HCP healthcare professional
Fig. 3
Fig. 3
Proportion of patients with chronic migraine versus episodic migraine within each center. EM episodic migraine, CM chronic migraine
Fig. 4
Fig. 4
Proportion of patients with chronic migraine versus episodic migraine within each country. EM episodic migraine, CM chronic migraine
Fig. 5
Fig. 5
Waiting list in OECD countries for new patient visits (mean waiting times). OECD Organisation for Economic Co-operation and Development
Fig. 6
Fig. 6
Dedicated nurse distribution in headache clinics across countries
Fig. 7
Fig. 7
Internal follow-up of patients
See this image and copyright information in PMC

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