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Providing support for migraine clinicians and patients

Being able to effectively obtain and use health information is an essential element of empowering and supporting patients to self-manage their chronic conditions. Supporting people to self-manage their health conditions through systematic provision of education and supportive interventions increases their skills and confidence and improves outcomes for patients – ranging from quality-of-life and clinical outcomes, to reduced healthcare utilisation including hospitalisation.

The Migraine Association of Ireland (MAI) is Ireland’s only patient organisation for people suffering from migraine and other headache disorders. It is estimated that over 500,000 people suffer from migraine in Ireland. While 14-15 per cent of these people are chronic migraine patients (more than 15 days migraine per month) and will require specialist treatment and preventative medications, most migraine sufferers experience episodic attacks. Episodic migraine attacks can be effectively reduced and managed with lifestyle and dietary adaptations. Learning to identify triggers is a key element of an effective migraine management programme.

Self-education and self-management can also prevent an over-reliance on over-the-counter medications, which can give rise to medication overuse headache. In 2011, the Dublin Neurological Institute undertook an audit of patients attending their specialist migraine clinic and they found that medication overuse headache was present in 52 per cent of patients attending the clinic.

Education and self-management supports

The MAI provides a number of free seminars for migraine sufferers throughout the year covering a variety of themes from ‘Hormonal Migraines in Women’, ‘Migraine in Children and Teens’ to general migraine seminars helping people better understand their condition. We also run a self-management course, over three weeks, one evening a week and during this course patients are connected with medical experts from the national migraine clinics to receive specialist training and advice on their condition. The course also equips people with the skills and strategies to better manage their condition. Modules include the migraine friendly diet, supplements for migraine prevention, identifying triggers, exercise and stress reduction techniques. We have also incorporated cognitive behavioural therapy (CBT) techniques in our programme so we can help people accept that migraine is a neurological condition they may always have and to adapt their expectations and lifestyle choices around the condition rather than always searching for a cure.

If GPs have patients who are suffering regular migraines, a referral to the MAI can be a positive first step in achieving better patient outcomes. The MAI also operates an information and support line that patients can call for support and advice and through this they can also be referred to a specialist migraine nurse.

Another key challenge for migraine sufferers internationally is that migraine remains undiagnosed and undertreated in at least 50 per cent of patients. On average migraine sufferers are taking six-to-seven years to receive a proper diagnosis of migraine.

Irish GPs currently only receive four hours training in headache as part of their undergraduate training. This is despite the fact that migraine is the most common primary headache seen by GPs. Three-quarters of the patients presenting to the Migraine Clinic at the Dublin Neurological Institute in the Mater Hospital, Dublin, have never been prescribed a preventative therapy, which indicates there is a serious lack of knowledge about chronic migraine in the primary care setting.

Resources for healthcare professionals

The MAI in recognition of this challenge provides a number of specialist health professional training seminars, for GPs and other healthcare professionals throughout the year. We have been in existence for nearly 25 years and through our network of contacts at a national and international level we have the ability to attract a high calibre of headache and migraine experts. The events are free to attend and carry RCPI and NMBI CPD points. We also have a comprehensive health professional section on our website, www.migraine.ie, which provides in depth diagnostic materials and resources. The patient section of our website is also a good referral tool for GPs to direct migraine patients to so they can better understand their condition.

You can email or contact the MAI on info@migraine.ie or 01 894 1280. The MAI Information and Support Line operates Monday to Friday 10-4 pm and the number is 1850 200 378.

Our book Migraine Not Just Another Headache is also available to buy from local bookshops and from our website.

Written by experts, this book describes the role of the GP, nurse, pharmacist, paediatrician, physiotherapist and psychologist in the treatment of migraine. It advises about the management of migraine in the home, at school, in the sports centre and workplace. It gives crucial information from neurology and from specialist migraine clinics about pain management, migraine in children and adolescents, and the legislation to support people in educational and employment contexts.

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