Patterns of health care utilization for migraine in England and in the United States

Richard B. Lipton, A. I. Scher, T. J. Steiner, M. E. Bigal, K. Kolodner, J. N. Liberman, W. F. Stewart

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Objective: To assess patterns of medical consultation, diagnosis, and medication use in representative samples of adults with migraine in England and the United States. Methods: Validated computer-assisted telephone interviews were conducted in the United Kingdom (n = 4,007) and the United States (n = 4,376). Individuals who reported six or more headaches per year meeting the criteria for migraine were interviewed. Results: Patients with migraine in the United Kingdom were more likely to have consulted a doctor for headache at least once in their lifetime (86% vs 69%, p < 0.0001), but also were more likely to have lapsed from medical care (37% vs 21%, p < 0.001). In the United States, patients with migraine who had consulted made more office visits for headache and were more likely to see a specialist. In the United States, but not in the United Kingdom, women with migraine were more likely than men to consult doctors for headache. Patients with migraine in the United Kingdom were more likely to receive a medical diagnosis of migraine (UK 67%, US 56%; p < 0.05). Patterns of medication use were similar in both countries, with most people treating with over-the-counter (OTC) medications. Substantial disability occurred in a high proportion of those who never consulted (UK 60%, US 68%), never received a correct medical diagnosis (UK 64%, US 77%), and treated only with OTC medication (UK 72%, US 70%). Conclusion: Medically unrecognized migraine remains an important health problem both in the United States and the United Kingdom. Furthermore, there may be barriers to consultation for men in the United States that do not operate in the United Kingdom.

Original languageEnglish (US)
Pages (from-to)441-448
Number of pages8
JournalNeurology
Volume60
Issue number3
StatePublished - Feb 11 2003

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Patient Acceptance of Health Care
Migraine Disorders
England
Headache
Referral and Consultation
Office Visits
United Kingdom
Interviews

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Lipton, R. B., Scher, A. I., Steiner, T. J., Bigal, M. E., Kolodner, K., Liberman, J. N., & Stewart, W. F. (2003). Patterns of health care utilization for migraine in England and in the United States. Neurology, 60(3), 441-448.

Patterns of health care utilization for migraine in England and in the United States. / Lipton, Richard B.; Scher, A. I.; Steiner, T. J.; Bigal, M. E.; Kolodner, K.; Liberman, J. N.; Stewart, W. F.

In: Neurology, Vol. 60, No. 3, 11.02.2003, p. 441-448.

Research output: Contribution to journalArticle

Lipton, RB, Scher, AI, Steiner, TJ, Bigal, ME, Kolodner, K, Liberman, JN & Stewart, WF 2003, 'Patterns of health care utilization for migraine in England and in the United States', Neurology, vol. 60, no. 3, pp. 441-448.
Lipton RB, Scher AI, Steiner TJ, Bigal ME, Kolodner K, Liberman JN et al. Patterns of health care utilization for migraine in England and in the United States. Neurology. 2003 Feb 11;60(3):441-448.
Lipton, Richard B. ; Scher, A. I. ; Steiner, T. J. ; Bigal, M. E. ; Kolodner, K. ; Liberman, J. N. ; Stewart, W. F. / Patterns of health care utilization for migraine in England and in the United States. In: Neurology. 2003 ; Vol. 60, No. 3. pp. 441-448.
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