Approximately 36% of patients who meet criteria for chronic migraine and consult a headache specialist receive a diagnosis of chronic migraine. Of patients who meet criteria and consult with a nonheadache specialist, about 16% receive a diagnosis of chronic migraine. Researchers reported this at the 66th Annual Meeting of the American Academy of Neurology.

These low rates of appropriate diagnosis are “a barrier to optimal care, as diagnosis is necessary for designing an optimal treatment plan, which may include diagnosis-specific treatments,” said Dawn C. Buse, PhD, Associate Professor of Neurology at Albert Einstein College of Medicine in the Bronx, New York.

Diagnoses of migraine and chronic migraine are made more often by headache specialists than by other health care practitioners. But most respondents with chronic migraine do not receive a diagnosis of chronic migraine, even among those who consult a headache specialist. Patients who see only a nonprescribing health care practitioner are the least likely to have ever received a diagnosis of migraine, chronic migraine, transformed migraine or chronic daily headache. More respondents with chronic migraine are currently consulting a nonprescribing health care practitioner than a headache specialist.

Said Dr. Buse, “These data demonstrate gaps in the diagnosis, treatment and knowledge of individuals with chronic migraine in the United States and offer opportunities for improvement in care.”

Dr. Buse and colleagues have developed the Identify Chronic Migraine screening tool. She and her colleagues drafted a list of 19 candidate test items, based on a review of existing screening instruments and suggestions from a panel of 8 international headache experts. The panel then helped the researchers create a questionnaire from the item list.

The researchers plan to develop item-scoring criteria for the screening tool, said Dr. Buse. They also plan to compare screening diagnoses using structured interviews conducted by headache experts.     Neurology Reviews    August 2014


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