Migraine is a common and disabling neurological disease, but a University of Otago (Wellington) study has found the cost, availability and accessibility of care means many patients are not getting the help they need.
Research co-author, general practitioner and Otago University primary healthcare and general practice senior lecturer Dr Jonathan Kennedy said primary care clinicians were interviewed as part of the study, which found people with migraine faced several significant barriers in accessing help.
"Primary care clinicians have the knowledge to effectively manage most people with migraine.
"However, existing problems in the healthcare system, such as cost, availability of appointments and waiting times — for both primary care and specialist neurological assessment — create barriers to help-seeking and management.
"This is especially the case for people who cannot afford private care and unfunded medications."
More than 750,000 people in New Zealand experience migraine.
The study found healthcare costs discouraged many patients from initial engagement with a doctor, along with follow-up and ongoing care.
Variation in access to specialist neurology care also disadvantaged those who could not access private services, and long waiting times and inability to register with primary care resulted in the perceived neglect of conditions such as migraine.
Dr Kennedy said it was particularly true among communities experiencing healthcare disparities, where a higher burden of other illness, combined with financial and discriminatory barriers, could put pressure on consultation time.
"We know disparities are greater when the primary healthcare system is based on reactivity, restricted availability and fees rather than relationships, trust, outreach and cultural safety."
The study, and others like it, showed people’s physical and mental health, work and quality of life suffered.
When appropriate treatment and specialist investigation and reassurance were not available, it increased pressure on primary care clinicians.
The latest research showed the need for investing in, and growing, the highly skilled primary healthcare workforce and all the systems that support it, such as specialist outpatient services in New Zealand.
"Good understanding and up-to-date knowledge about migraine ... helps ensure people are aware of treatment options, and challenges stigmatising beliefs about migraine being ‘just a headache’."
