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Communication Found Lacking in Chronic Migraine Treatment

Quality communication is critical between patients and health care professionals, but a new study has found that it often falls short between patients with chronic migraine and their physicians. This situation leads to suboptimal treatment, according to a new study that included 20 neurologists from around the country.

Researchers analyzed transcribed audio recordings from 67 patient visits for several communication strategies important in migraine-related care, including what is called the “ask-tell-ask” strategy. This technique involves a physician inquiring about a problem, the patient responding, and the physician rephrasing the answer; it is considered optimal for migraine treatment. They found a variety of shortcomings in content and style of communication.

  • Open-ended questions, which are recommended to initiate a dialogue about chronic migraine, were used in just 4% of encounters.
  • Migraine attacks, which often last more than a day, and days with migraine were distinguished just 4% of the time.
  • Headache-related disability was discussed in only 30% of encounters.
  • The diagnosis “chronic migraine” was mentioned in just 9% of visits, and treatment plans were discussed in only 37% of visits.

“The study shows we can do much better,” said one of the lead researchers, Richard Lipton, MD, in a press release. “Effective medical communication is vital to accurate diagnosis, optimizing treatment plans, and facilitating patient adherence. We found that recording actual physician-patient encounters provides a powerful tool for evaluating communication. The next step is to see if improving communication will improve treatment outcomes.”

Dr. Lipton and Dawn C. Buse, PhD, both of the Montefiore Headache Center and the Albert Einstein College of Medicine, led the study, which was presented at the annual scientific meeting of the American Headache Society in June in Washington, D.C.

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