There hasn’t been much research in Aotearoa New Zealand into how much health professionals know about the diagnosis and optimal treatment of migraine. One study of emergency departments in Australia and New Zealand found that evidence-based treatment recommendations were not routinely followed, with missed opportunities to provide the most effective management to patients with moderate to severe migraine attacks.
Internationally, studies have shown that primary care physicians (general practitioners, GPs) lack knowledge about preventive treatments for migraine (including non-medication treatments) and lack confidence in prescribing them, and may be unaware that overuse of acute medications can cause headache. This means many people with migraine aren’t provided with all or any of the options to help them control attacks, which may increase their risk of progression to chronic migraine and medication overuse. Also, GPs who don’t have good information about managing migraine confess to a sense of ‘dread’ when confronted with a migraine patient, which can exacerbate the stigma associated with migraine disease.
In our 2022 Migraine in Aotearoa New Zealand Survey, we asked respondents to rate the knowledge of migraine and treatment options in the health professionals they had seen. (Those who had seen more than one were asked to rate the one seen most recently.) Possible responses were excellent, very good, good, fair and poor, with the option of indicating that the health professional hadn’t been seen, so the question wasn’t applicable. For this type of rating, ‘fair’ is considered barely satisfactory, and ‘poor’ definitely not satisfactory, with ‘good’ as the middling category and ‘very good’ or ‘excellent’ indicating a progressively higher appreciation and satisfaction with health professionals’ knowledge.
For 12 of the health professional types we asked about, at least 100 survey respondents provided a rating of their migraine knowledge. As previously reported, GPs were the health professional most commonly accessed for migraine treatment, but many other health and allied health professionals can be involved in the care of people with migraine.