1
|
McPhee D, Brown CC, Robinson WD, Jarzynka K. Receiving Medical Care for Chronic Migraines: A Phenomenological Study. South Med J 2022; 115:270-275. [PMID: 35365844 DOI: 10.14423/smj.0000000000001382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Treating chronic migraine (CM) effectively is one of the greatest challenges a primary care provider (PCP) may encounter. Many patients with CM report dissatisfaction and minimal gains from treatment, despite using the best medical interventions available. For this study, patients with CM and their partners provided insight into how PCPs could improve CM treatment. METHODS Using the immersion/crystallization phenomenological method, we collected data from 11 patients with CM and 8 of their partners (N = 19). We analyzed open-ended survey responses about migraine treatment from patients with CM, as well as transcripts from interviews with patients with CM and their partners (14 interviews total) about their medical experiences. RESULTS Participants used a variety of pharmacological and alternative treatments in search of a cure; wanted to be treated more collaboratively; and repeatedly gave up on medical care, but then sought treatment again. CONCLUSIONS PCPs could be trained to encourage patients with CM to shift toward accepting and managing migraines rather than endlessly hoping for a cure. Patients could be taught to manage CM using a holistic, biopsychosocial approach.
Collapse
Affiliation(s)
- Douglas McPhee
- From Marriage and Family Therapy Program, Mount Mercy University, Cedar Rapids, the Department of Community, Family and Addiction Sciences, Texas Tech University, Lubbock, the Department of Human Development and Family Studies, Utah State University, Logan, and the Department of Family Medicine, University of Nebraska Medical Center, Omaha
| | - Cameron C Brown
- From Marriage and Family Therapy Program, Mount Mercy University, Cedar Rapids, the Department of Community, Family and Addiction Sciences, Texas Tech University, Lubbock, the Department of Human Development and Family Studies, Utah State University, Logan, and the Department of Family Medicine, University of Nebraska Medical Center, Omaha
| | - W David Robinson
- From Marriage and Family Therapy Program, Mount Mercy University, Cedar Rapids, the Department of Community, Family and Addiction Sciences, Texas Tech University, Lubbock, the Department of Human Development and Family Studies, Utah State University, Logan, and the Department of Family Medicine, University of Nebraska Medical Center, Omaha
| | - Kimberly Jarzynka
- From Marriage and Family Therapy Program, Mount Mercy University, Cedar Rapids, the Department of Community, Family and Addiction Sciences, Texas Tech University, Lubbock, the Department of Human Development and Family Studies, Utah State University, Logan, and the Department of Family Medicine, University of Nebraska Medical Center, Omaha
| |
Collapse
|
2
|
Couples Living with Chronic Migraines: A Phenomenological Study. CONTEMPORARY FAMILY THERAPY 2019. [DOI: 10.1007/s10591-019-09513-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
3
|
Davidson I, Crooks K, Newington L, Pilling M, Todd C. Assessing the feasibility of mobilisation of C0–C3 cervical segments to reduce headache in migraineurs. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.8.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ian Davidson
- Senior lecturer in physiotherapy, Manchester Metropolitan University
| | - Kathryn Crooks
- Research assistant, School of Nursing, Midwifery and Social Work, University of Manchester
| | - Lisa Newington
- Senior physiotherapist, Chelsea and Westminster Hospital NHS Foundation Trust, London
| | - Mark Pilling
- Senior research associate in statistics, Institute of Public Health, University of Cambridge
| | - Christopher Todd
- Professor of primary care and community health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre and Manchester University NHS Foundation Trust
| |
Collapse
|
4
|
Predicting prognostic factors in a randomized controlled trial of acupuncture versus topiramate treatment in patients with chronic migraine. Clin J Pain 2014; 29:982-7. [PMID: 23370087 DOI: 10.1097/ajp.0b013e31827eb511] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to identify predictive factors of outcome in patients with chronic migraine (CM) treated with acupuncture or topiramate in a randomized controlled trial. METHODS Sixty-six consecutive CM patients were treated with either acupuncture (n=33) or topiramate (n=33) in a 12-week period. Data on potential predictive factors were collected at baseline, and secondary data analysis was performed to identify factors associated with treatment response. Treatment prognosis was defined as the change in mean number of moderate/severe headache days per 4 weeks from the 4-week baseline periods. RESULTS The median change in mean number of moderate/severe headache days per 4 weeks for patients with higher baseline headache days (>20 d) was significantly greater than that for lower baseline headache days (≤ 20 d) (median ± interquartile range: -12 ± 2 vs. -10 ± 1 d, P=0.01) in acupuncture group. There was a greater change in mean number of moderate/severe headache days per 4 weeks for high moderate/severe headache days (>20 d) than in low days (≤ 20 d) (-12 ± 1 vs. -10 ± 2 d, P=0.015) in acupuncture group. patients with throbbing symptoms had better prognosis with acupuncture than those without throbbing (-12 ± 2 vs. -9.5 ± 2.5 d, P=0.004). Higher score (>5 points) in the general expectations for improvement predicted better response in both treatment groups (>5 vs. ≤ 5 points: -12 ± 2 vs. -9 ± 2 d for acupuncture group; -10 ± 3 vs. -7 ± 4 d for topiramate group; P<0.001). CONCLUSIONS Some variables can predict outcome in acupuncture or topiramate treatment of CM patients. Identifying predictors of prognosis of both treatments for CM may help improve outcomes in future work.
Collapse
|