Closing Care Gaps by Thinking, Talking, and Treating Migraine

For as long as she can remember, Maria Galli, a professional photographer, entrepreneur, and business owner based in Miami, Florida, has experienced migraine, but it wasn’t until her mid-20s that it became debilitating. A self-described “go getter,” Maria wasn’t going to let anything, not even migraine, stop her from achieving her goals, so she took action.

There was one problem, however. Her doctors didn’t take her concerns seriously.

Unfortunately, Maria’s healthcare providers dismissed her migraine symptoms as part of “menstrual period pains,” even when she knew it was something else. Maria had to become a strong advocate for herself to get the proper diagnosis, treatment, and support she needed. In fact, it took Maria nearly 20 years and more than 8 doctors to find a care team and treatment plan for her migraine that worked for her.

Maria is just one of more than 30 million American adults living with migraine.¹ Her powerful story is evidence of the gaps in care people with migraine can face. In fact, a recent population-based survey study conducted by Eli Lilly and Company, called OVERCOME, found that only 56% of those seeing a neurologist are taking a recommended preventive medication, highlighting the need for improvement in migraine care.²

To help close these gaps, Lilly launched Think Talk Treat Migraine®, an initiative to help encourage patients to have conversations with their neurologists about the impact of migraine that can lead to proper and timely diagnosis and treatment. Think Talk Treat Migraine® strives to help neurologists overcome numerous barriers in a busy practice, including managing medical issues, identifying patients most in need of treatment, and creating high-yield conversations. There are 3 core components of the program: 1) Think, 2) Talk, and 3) Treat.

The first component, Think, focuses on thinking about the signs and symptoms of migraine and taking them into consideration when seeing patients. Headache, the overall impact of migraine on a patient’s daily life, sensitivity to light, and nausea are the key signs and symptoms of this disease. As you’ve seen from Maria’s story, migraine attacks can be underestimated and left undiagnosed---sometimes for years.

The second component, Talk, is aimed at fostering in-depth discussions between you and your patients about migraine during every visit. As neurologists, you should conduct a proactive assessment of migraine and encourage patients to share details about the frequency and impact of migraine on their daily lives, as patients often hesitate to share their full experience due to concerns that they won’t be taken seriously.³ In addition to migraine attacks, patients also may experience interictal burden, or worry between attacks, which can add to patients’ overall disease burden. Some examples of high-yield questions to ask patients include:⁴

• How many days in a month does headache impact your life?
• How has migraine impacted your daily activities?
• How often are you taking acute medication?

The last component is Treat. By keeping migraine signs and symptoms top of mind and providing a safe space for patients to share the full impact of this disease on their lives, you can better personalize care and determine treatment recommendations. Unfortunately, many patients seek care for years before they find a care team or treatment plan that works for them, just like Maria experienced. It’s critical to determine a patient’s symptoms quickly and distinguish whether they require an acute or preventive treatment based on how many monthly migraine headache days they experience. Acute treatment is recommended if patients experience 1 or more days of migraine symptoms per month, and if patients experience migraine symptoms for 4 or more days per month, acute and preventive treatment is recommended.⁵ When establishing a treatment plan with patients, neurologists also should confirm their patients’ understanding of their diagnoses and check in regularly with them at every visit to see if their current treatment is working properly or if adjustments are needed.

For patients like Maria, it was finding the right healthcare provider who truly listened and worked with her to find the right treatment plan that made all the difference. Neurologists can help patients receive proper and timely care by remembering the core components of Think Talk Treat Migraine®. To learn more about the program and find tools and resources to help facilitate meaningful conversations with patients, please visit thinkmigraine.com/hcp.

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