Barriers to Care Exist in Chronic Migraine

Less than 25% received an accurate diagnosis.

There is a significant unmet need to minimize barriers to care for patients with chronic migraine.

Results from the large Chronic Migraine Epidemiology and Outcomes (CaMEO) Study detail several barriers that are traversed by patients in the process of seeking appropriate care and treatment for chronic migraine. The results also identify several factors that identify which kind of patient may seek consultation for their migraines.

In order to better understand these barriers, researchers led by David W. Dodick, MD, of Mayo Clinic, conducted a longitudinal web-based panel in participants with chronic migraine. All participants had evidence of headache-related disability and provided data on health insurance status.

In total, 80 783 respondents provided data. Of those, 1476 met criteria for chronic migraine, and ultimately 1245 (85%) met inclusion criteria for the analysis. Over 40% of participants reported currently consulting with a health care professional for headache. The odds of doing so increased with age (OR 1.02; 95% CI 1.01–1.03), body mass index (BMI) (OR 1.01; 95% CI 1.00–1.03), migraine-related disability (OR 1.02; 95% CI 1.00–1.04), migraine severity (OR 1.16; 95% CI 1.11–1.22) and presence of health insurance (OR 4.61; 95% CI 3.05–6.96). Over 24% (126) of those consulting with a health care professional received an accurate diagnosis, 56 of whom went on to receive both acute and preventive drug treatment.

Odds of a diagnosis were greater for women (OR 1.93; 95% CI 1.03–3.61), those with greater migraine severity (OR 1.25; 95% CI 1.14–1.37), and those currently consulting a specialist (OR 2.38; 95% CI 1.54–3.69). Overall, only 56 participants traversed consultation, diagnosis, and pharmacological treatment to successful chronic migraine care.

The results suggest that a considerable effort to improve interventions and education in order to improve rates of consultation, diagnoses, and treatment is needed.


Dodick DW, Loder EW, Adams AM, et al. Assessing Barriers to Chronic Migraine Consultation, Diagnosis, and Treatment: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Headache. 2016; doi: 10.1111/head.12774.