I'm Getting a Migraine: A Comparative Evaluation of Patient and Clinician Interpretations of Migraine Symptoms

Overview

Journal Ochsner J

Specialty General Medicine

Date 2024 Dec 25

PMID 39720823

Authors

Jakob L Fischer

Anthony M Tolisano

Alvaro I Navarro

Waleed M Abuzeid

Ian M Humphreys

Nadeem A Akbar

Sharan Shah

John S Schneider

Charles A Riley

Edward D McCoul

Affiliations

Soon will be listed here.

Abstract

Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians. Between June 2020 and October 2022, patients and otolaryngology providers at 5 academic medical centers were asked to select as many symptoms as they felt were related to migraine from a list of 28 common symptom terms in 6 domains: headache-related, eye-related, systemic, sinonasal, facial, and ear-related. The primary study outcome was to assess the differences in patient and clinician perceptions of migraine-related symptoms. A secondary outcome was to assess differences by geographic location. A total of 381 patients and 31 otolaryngology clinicians participated. Patients and providers selected a similar number of symptom terms to define migraine, selecting a median of 10 and 11 symptoms, respectively. Otolaryngology clinicians were more likely than patients to define migraine using eye-related symptoms (difference 10.5%; 95% CI 7.4%, 13.6%) and ear-related symptoms (difference 17.2%; 95% CI 3.4%, 31.0%). Patients were more likely to define migraine using facial symptoms (difference -17.3%; 95% CI -34.1%, -0.5%). Otolaryngologists and patients were equally likely to select headache-related, sinonasal, and systemic symptoms when defining migraine. Minor differences were identified based on geographic location. We found differences between otolaryngologists and their patients in the interpretation of the symptoms of migraine. Clinicians were more likely than patients to describe migraine using eye-related and ear-related symptoms, whereas patients were more likely to describe migraine using facial symptoms. These findings have important counseling and communication implications for clinicians.

References

Rasmussen B, Olesen J . Migraine with aura and migraine without aura: an epidemiological study. Cephalalgia. 1992; 12(4):221-8; discussion 186. DOI: 10.1046/j.1468-2982.1992.1204221.x. View

Ziegeler C, Brauns G, Jurgens T, May A . Shortcomings and missed potentials in the management of migraine patients - experiences from a specialized tertiary care center. J Headache Pain. 2019; 20(1):86. PMC: 6734431. DOI: 10.1186/s10194-019-1034-8. View

Gvantseladze K, Do T, Hansen J, Shapiro R, Ashina M . The Stereotypical Image of a Person With Migraine According to Mass Media. Headache. 2020; 60(7):1465-1471. DOI: 10.1111/head.13846. View

Moore P, Rivera Mercado S, Grez Artigues M, Lawrie T . Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev. 2013; (3):CD003751. PMC: 6457800. DOI: 10.1002/14651858.CD003751.pub3. View

Schreiber C, Hutchinson S, Webster C, Ames M, Richardson M, Powers C . Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache. Arch Intern Med. 2004; 164(16):1769-72. DOI: 10.1001/archinte.164.16.1769. View

Basura G, Adams M, Monfared A, Schwartz S, Antonelli P, Burkard R . Clinical Practice Guideline: Ménière's Disease. Otolaryngol Head Neck Surg. 2020; 162(2_suppl):S1-S55. DOI: 10.1177/0194599820909438. View

Fischer J, Watson N, Tolisano A, Riley C . Assessing health literacy in rhinologic patients. Int Forum Allergy Rhinol. 2020; 11(4):818-821. DOI: 10.1002/alr.22733. View

Sommerfeldt J, Fischer J, Morrison D, McCoul E, Riley C, Tolisano A . A Dizzying Complaint: Investigating the Intended Meaning of Dizziness Among Patients and Providers. Laryngoscope. 2020; 131(5):E1443-E1449. DOI: 10.1002/lary.29271. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008. View

10.

Van Ombergen A, Van Rompaey V, Van de Heyning P, Wuyts F . Vestibular migraine in an otolaryngology clinic: prevalence, associated symptoms, and prophylactic medication effectiveness. Otol Neurotol. 2014; 36(1):133-8. DOI: 10.1097/MAO.0000000000000596. View

11.

Fischer J, Tolisano A, Navarro A, Trinh L, Abuzeid W, Humphreys I . Layperson Perception of Reflux-Related Symptoms. OTO Open. 2023; 7(2):e51. PMC: 10167538. DOI: 10.1002/oto2.51. View

12.

Tolisano A, Fang L, Isaacson B, Kutz Jr J, Hunter J . Can You Hear Me Now? The Impact of Hearing Loss on Patient Health Literacy. Otol Neurotol. 2020; 41(8):1027-1032. DOI: 10.1097/MAO.0000000000002713. View

13.

Hu S, Helman S, Filip P, Cabin J, Colley P . The role of the otolaryngologist in the evaluation and management of headaches. Am J Otolaryngol. 2018; 40(1):115-120. DOI: 10.1016/j.amjoto.2018.07.002. View

14.

Russell M, Rasmussen B, Fenger K, Olesen J . Migraine without aura and migraine with aura are distinct clinical entities: a study of four hundred and eighty-four male and female migraineurs from the general population. Cephalalgia. 1996; 16(4):239-45. DOI: 10.1046/j.1468-2982.1996.1604239.x. View

15.

Stovner L, Hagen K, Linde M, Steiner T . The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain. 2022; 23(1):34. PMC: 9004186. DOI: 10.1186/s10194-022-01402-2. View

16.

. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38(1):1-211. DOI: 10.1177/0333102417738202. View

17.

Burch R, Buse D, Lipton R . Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019; 37(4):631-649. DOI: 10.1016/j.ncl.2019.06.001. View

18.

Raffaelli B, Kull P, Mecklenburg J, Overeem L, Storch E, Terhart M . Patients' and Health Care Workers' Perception of Migraine Images on the Internet: Cross-sectional Survey Study. J Med Internet Res. 2021; 23(11):e32707. PMC: 8663508. DOI: 10.2196/32707. View

19.

Babicki S, Arndt D, Marcu A, Liang Y, Grant J, Maciejewski A . Heatmapper: web-enabled heat mapping for all. Nucleic Acids Res. 2016; 44(W1):W147-53. PMC: 4987948. DOI: 10.1093/nar/gkw419. View

20.

Viticchi G, Silvestrini M, Falsetti L, Lanciotti C, Cerqua R, Luzzi S . Time delay from onset to diagnosis of migraine. Headache. 2010; 51(2):232-6. DOI: 10.1111/j.1526-4610.2010.01778.x. View