A 10-Year Report Card Shows Migraine Remains Underdiagnosed and Undertreated

CHICAGO, February 22, 2000 – A new study – the American Migraine Study II – reports that patient treatment patterns have not kept pace with major scientific breakthroughs in the field. Unfortunately, despite a better understanding of the disease and medications designed specifically for the treatment of migraine, many patients continue to experience needless pain and disability.

The study examines the state of migraine care over the past decade and shows the majority of patients report severe disability and the need for bedrest due to an inability to control their headache pain and associated migraine symptoms. The study reveals that the 48 percent of sufferers who have received a diagnosis from a doctor suffer to a similar degree as those who have never had their migraines diagnosed. This shows that effective control of migraine is dependent not only on diagnosis but on the treatment received once in the physician’s care.
The study was conducted for the National Headache Foundation (NHF) and underwritten by a grant from Glaxo Wellcome Inc. (now GlaxoSmithKline). Results from the study were released at the 13th Annual Conference of the Diamond Headache Clinic Research and Education Foundation, held in Palm Springs, Calif.

In response to these dramatic results, the National Headache Foundation convened a meeting of professional and consumer medical organizations. The groups are now calling for a renewed commitment to the diagnosis and treatment of migraine from health care professionals and better education of patients.

“We hope this call to action and coming together of health care professionals from a wide range of disciplines will help us close the gap between the effective treatments available and the millions who continue to suffer from migraine,” says Suzanne Simons, executive director of the NHF.

In the survey, subjects answered a series of questions about their diagnosis and treatment history and the impact of migraine on their lives. The sample was determined to be representative of the U.S. population in terms of household income, ethnicity, family size and other factors. The study examines the current state of migraine care in the U.S. It updates a methodologically identical study by the same research team conducted 10 years ago and published in the Journal of the American Medical Association.[1]

Among key findings of the research were:

  • Total U.S. migraine prevalence was virtually the same in 1999 (12.6 percent) as in 1989 (12.1 percent) – current incidence (28 million) has increased since 1989 (24 million) with the growth in population.
  • Only 48 percent of respondents who met the clinical definition of migraine report ever having had their condition diagnosed by a physician.
  • 80 percent said their migraine headaches were severe or extremely severe, and 24 percent reported seeking emergency room care as a result of an attack.
  • Despite significant advances in prescription medications designed specifically to treat migraine, 57 percent of migraine headache sufferers report still using only over-the-counter medications for treatment, virtually the same percentage as 10 years ago (59 percent).
  • While sufferers with a physician diagnosis tend to have more severe migraines and report more symptoms versus the undiagnosed, there is a high level of suffering reported by both groups:
    • Throbbing pain (85 percent diagnosed vs. 85 percent undiagnosed)
    • Sensitivity to light (89 percent diagnosed vs. 72 percent undiagnosed)
    • Pain on one side of the head (64 percent diagnosed vs. 55 percent undiagnosed)
    • Nausea (80 percent diagnosed vs. 66 percent undiagnosed)

The new data show that one in every four U.S. households has a migraine sufferer. This is 13 percent of the American population. When left untreated, sufferers typically experience a significant deterioration in their quality of life. Fifty-one percent of sufferers said that during their migraine headaches they experienced a 50 percent or more reduction in work and/or school productivity and 66 percent said they experienced a 50 percent or more reduction in housework productivity. Thirty-nine percent of patients report migraine pain so severe they are driven to their beds – sometimes for days at a time.

“In the past, narcotic medications were widely used for migraine. Narcotics relieve pain, but often produce disabling sedation. The new generation of medicines, known as triptans, relieve pain and restore a persons ability to function, allowing people to get back to their lives,” says Richard B. Lipton, M.D., Professor of Neurology, Epidemiology and Social Medicine, at Albert Einstein College of Medicineand lead researcher of the study.

Another study of the life-impact issues surrounding migraine conducted for the National Headache Foundation, underwritten by a grant from Glaxo Wellcome Inc. (now GlaxoSmithKline) and released in June 1999, found that when migraine sufferers have their condition effectively treated, they report a significant improvement in their work, family and social lives. Additionally, the study revealed that users of migraine prescription medication, particularly triptans, report a high level of satisfaction with their overall treatment program.

“People with migraine headaches must see their doctors regularly,” says Simons. “If they’ve dropped out of the healthcare system and thought there was nothing that could be done for their headaches, they need to go back. People need to become more proactive and champion their own health.”

Of the 20,000 households targeted for the study, 13,869 households responded and returned their questionnaires (69 percent response rate). These households contained 29,258 individuals aged 12 and older; of these, 6,211 (21 percent) were severe headache sufferers and 3,738 (12 percent) had migraine as defined by established International Headache Society (IHS) criteria.

Study Sponsors:
The National Headache Foundation (NHF), founded in 1970, is a Chicago-based national nonprofit organization committed to promoting education and public awareness about the debilitating nature of headaches, and serves as the leading resource for headache sufferers, their families and health care providers. Information on membership, patient education materials and support groups is available by calling (888) NHF-5552, writing to NHF at 820 N. Orleans, Suite 411, Chicago, IL 60610, or visiting www.headaches.org. GlaxoSmithKline, one of the world’s leading research-based pharmaceutical and health care companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.

Note To Editors:
Migraine is a legitimate, biological disease characterized by throbbing head pain, usually located on one side of the head, often accompanied by nausea and sensitivity to light and/or sound. Migraine is more common than asthma, diabetes or congestive heart failure. The combination of disabling pain and associated symptoms often prevents sufferers from performing daily activities. Attacks occur periodically and can last from four to 72 hours. Symptoms, incidence and severity vary by individual and by attack.

Copies of the original 1989 study can be obtained by contacting

Mary Franklin
Director of Operations
National Headache Foundation

Largest Study Ever of Migraine Sufferers Reveals Preventive Therapies Remain Untapped