Do doctors treat themselves differently than their patients? Study on the self-treatment of migraine among German neurologists and pain specialists

Prevalence and self-management of migraine among neurologists and neurology residents in Turkey: do neurologists apply effective rational prophylaxis to their migraines?

AIM

The aim of the study to determine the migraine prevalence and self-management of migraine among the neurologists and neurology residents registered to the Turkish Neurological Society.

METHODS

This cross-sectional study includes 851 participants. Based on the "The International Classification of Headache Disorders, 3rd edition" and previous literature, an anonymous questionnaire was prepared and used to collect data online via Google Forms. The link to the study was posted on the website of the Turkish Neurological Society.

RESULTS

Women (73.2%) and neurologists (77.4%) made up the majority of the participants. Of the participants, 37.9% met the diagnosis criteria for migraine. Being women and positive family history were associated with migraine compared to the tension-type headache (TTH) (both p values < 0.001). Comparing with the TTH sufferers, migraine significantly hindered work, social, and family life (all p values < 0.001). Participants with migraine had more magnetic resonance imaging (MRI) (47.4%) and electroencephalography (EEG) (4.3%) than those with TTH (both p values < 0.05). Participants with migraine received drug prophylaxis more frequently (20.1%) than those with TTH (2.3%) (p < 0.001), and these drugs were selective serotonin reuptake inhibitors (SSRIs) (7.1%), beta-blockers (5.9%), and serotonin-norepinephrine reuptake inhibitors (SNRIs) (5.3%) (all p values < 0.05). Participants with migraine received non-pharmacological prophylaxis for headache more frequently (25.7%) compared to those with TTH (p < 0.001).

CONCLUSIONS

Migraine is common among neurologists and neurology residents. Identifying migraine self-management is important for preventing the loss of work and negative economic and social consequences that migraine may cause in these groups of physicians.

Migraine in physicians and final year medical students: A cross-sectional insight into prevalence, self-awareness, and knowledge from Pakistan

BACKGROUND

Despite its high prevalence, migraine remains underdiagnosed worldwide. A significant reason is the knowledge gap in physicians regarding diagnostic criteria, clinical features, and other clinical aspects of migraine.

AIM

To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.

METHODS

An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals, Faisalabad, between October 2018 and October 2019. Inclusion criteria were public practicing physicians who experience headaches, while those who never experienced headaches were excluded. Different questions assessed respondents on their knowledge of triggers, diagnosis, management, and prophylaxis of the migraine headache. They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine. Graphs, tables, and figures were made using Microsoft Office 2016 and Microsoft Visio, and data analysis was done in R Studio 1.4.

RESULTS

We had 213 respondents and 175 fulfilled inclusion criteria, with 99 (52%), 58 (30%) and 12 (6.3%) belonging to specialties of medicine, surgery, and others, respectively. Both genders were symmetrically represented (88 male and 87 female). Fifty-two (24.4%) of our 213 respondents were diagnosed with migraine, with 26 (50%) being aware of it. Females had higher prevalence among study participants (n = 28, 32.2%) compared to males (n = 20, 22.7%, P = 0.19). A majority (62%) of subjects never consulted any doctor for their headache. Similarly, a majority (62%) either never heard or did not remember the diagnostic criteria of migraine. Around 38% falsely believed that having any type of aura is essential for diagnosing migraine. The consultation rate was 37% (n = 65), and migraineurs were significantly more likely to have consulted a doctor, and a neurologist in particular (P < 0.001). Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts. There was no significant difference in other knowledge aspects between consulters versus non-consulters and migraineurs versus non-migraineurs.

CONCLUSION

Critical knowledge gaps exist between physicians and medical students, potentially contributing to misdiagnosis and mismanagement of migraine.

Are doctors accurate when diagnosing themselves with migraine? A study on migraine prevalence among doctors in a tertiary care hospital

Migraine is considered an underdiagnosed disease in general population. Different studies show a higher prevalence in neurologists. However, there are few studies about its prevalence in doctors of other specialties, where it could also be superior than in general population. Our aim was to define migraine lifetime prevalence among doctors according to three parameters (previous diagnosis, self-diagnosis and positivity of a screening test). Single-center, descriptive, cross-sectional study based on online surveys with collection of sociodemographic and clinical variables, addressed to doctors of a tertiary hospital. Participants who reported 5 or more headaches throughout their lives were considered "headache sufferers" and were divided in different groups according to their position (specialists or trainees) and their specialty (medical, medical-surgical and surgical or specialties with no direct contact with the patient). The Spanish validated version of the Migraine Screen Questionnaire (MS-Q) was used as screening test. There were 217 participants (response rate of 29%), 72% were women and 56% trainees, mean age 34 years (SD10). 77% were "headache sufferers" Among all participants, migraine lifetime prevalence according to diagnosis by another physician was 15.2%, self-diagnosis 38.2% and positivity of the MS-Q 20.3%; those categories were not mutually exclusive Greater but not statistically significant coexistence of self-diagnosis and positive MS-Q was seen in specialists compared to trainees and in medical specialties. Migraine prevalence among doctors in a tertiary care hospital was higher than in general population, according to all three parameters analyzed. Self-diagnosis was the highest which could reflect an overdiagnosis; further studies are needed to determine this possibility.