Patient Education, Resources

Good Q&A on Migraine Basics

My sister and her three kids visited over the weekend, so I haven’t had much time at the computer. I’ll resume regular blogging activities tomorrow (provided that I don’t have a migraine after the loud, frenzied and fun weekend), but there’s an article I’d like to share tonight.

Published in Glasgow, Scotland’s The Herald, A Head Start on Migraine is a simple Q&A on migraine. I like the article because it describes migraine as a complex neurological disease with a variety of symptoms and distinguishes it from a bad headache. Statistics of sufferers come from the UK, so it’s not totally generalizable, but its a good article to send to family and friends who would like to know more about what you go through (or who don’t believe that you have a disabling disease).

News & Research

News Roundup

It’s a busy day and there’s a lot of news from today and from the week that I have blogged about, so here are headlines and excerpts. They’re in reverse chronological order. I can’t shake the feeling that I’ve missed something. If you know of other relevant news, please post it in the comments. Thanks!

Self Reported Chronic Pain in School Age Children
“The results showed an incredible prevalence of chronic pain (defined as pain for longer than 3 months) at 44% of all responders. Headache was the most common source of pain (38%) closely followed by back pain (17%) and limb pain (15.7%). The effects on daily living tended to impact most significantly on ability to pursue hobbies (girls 60%, boys 57%); sleeping problems (girls 61%, boys 46%); eating problems (girls 48%, boys 30%) as well as numerous other normal adolescent activities.”

Pain, Fear of Pain and Expectancy as Indicators of Future Disability
In a study of people with chronic back pain, “…negative expectancies were associated with frequent pain and a belief that their condition was derived from a serious underlying medical problem. Patients with negative expectancy and a fear that activity might result in further injury, re-injury or increased pain, displayed significant differences in suffered pain and functional capacity at one year than those with a positive perspective and no fear.”

(I hate when folks assume that pain is caused or perpetuated by attitude, but I can see how expectations can play a role in perpetuating or increasing pain.)

Cigna Offers its Customers Drug Data
Cigna “…has set up a Web site to help its customers find the lowest prices charged by pharmacies for prescription drugs. The site shows prices, including the patient’s out-of-pocket spending, for 52,000 pharmacies nationwide, as well as for mail- order or home-delivery service, the Philadelphia-based company insurer said. Consumers also can compare the costs of brand-name medicines with generic copies.”

(via Kaiser Networks’ daily reports)

Wall Street Journal Examines Efforts by Pharmaceutical Companies To ‘Revamp’ Image
“The Wall Street Journal on Friday examined efforts by pharmaceutical companies to ‘revamp their image’ in response to consumer criticism over high prices, safety concerns and ‘aggressive’ advertising. Opinion polls indicate that consumers consider the pharmaceutical industry to be one of the ‘least trusted’ industries….”

Wall Street Journal Examines Evaluations of Clinical Trials by Health Insurers, Others
“The Wall Street Journal on Wednesday examined research by insurers, state Medicaid programs and not-for-profit groups to evaluate clinical trials for prescription drugs and identify any ‘marketing spin’ included in studies published in medical journals.”

Drug Trials and the Media
“Media reports of drug trials can lack accuracy and reliability, according to a study published in the open access journal BMC International Health and Human Rights. Researchers say that in controversial issues such as HIV/AIDS prevention drug trials, investigators and funders should engage with the media to avoid misinterpretation and inaccurate reporting.”

(This is specifically about HIV/AIDS drug trials, but the issues are relevant throughout drug trials.)

Understanding the Relationship Between Pain, Impairment and Physical Disability
“The association between pain, impairment and disability is frequently observed in clinical practice but the relationship is not as straight-forward as just one to one; for example some patients may have severe pain but little impairment. Consequently, a group of investigators from University of Bergen in Norway set about trying to establish a more concrete idea of the interaction between these relative dimensions to quality of life.”

St. Jude Medical Announces IDE Approval to Begin ESCAPE Migraine Study
“St. Jude Medical believes it is the first company to receive FDA conditional approval to study the potential connection between Patent Foramen Ovale (PFO) closure and migraine headaches. A PFO is a structural defect of the heart where a small hole between the right and left atria (upper chambers of the heart) fails to close in infancy. An estimated 25% of the adult population has a PFO but in most people it is usually considered benign.

…The objective is to determine if patients who undergo a PFO closure procedure have a decreased number of migraines over a one year follow-up period as compared to those who are maintained only on drug therapy. Enrollment in the study is expected to begin by the end of 2005.”

First Detailed Picture of Migraine Attack
“Using a new method, researchers at Göteborg have managed for the first time ever to provide a detailed picture of an untreated attack. This will be of great significance for the development of new forms of treatment.”

News & Research, Society

Addressing Obstacles for Working Migraineurs in the UK

In response to Headache UK‘s study findings that one in four people keep their headaches a secret to avoid discrimination at work (Hidden Headaches in the UK), The Migraine Trust will launch a yearlong effort to expose the difficulties that migraineurs face at work. The campaign, which will begin during the UK’s Migraine Awareness Week (Sept. 4-10), will include collaboration with government, publication of a fact sheet on working with migraine and recognition of employers who address the needs of migraine sufferers.

A successful campaign could be a step toward awareness in the rest of the world, too.

News & Research

Studies on Living with Chronic Pain

It’s important to have clinical studies to describe and quantify what it’s like to live with chronic pain, but sometimes I read the news and think, “Well, of course.” Two studies presented at the International Association for the Study of Pain’s 11th World Congress of Pain that elicited this response were Study Suggests it is Unsafe to Drive when Suffering from Chronic Pain and An Evaluation of the Impact of Chronic Pain on Quality of Life. Again, they are valuable studies, but people with chronic pain have known these things for years.

An interesting aspect of the second study is that headache is described as localized pain that doesn’t affect the whole body, thus doesn’t reduce quality of life as much as full body pain, like fibromyalgia. While I can’t compare the pain to fibromyalgia, I don’t think of headache as confined to the head. Or am I confusing headache with migraine?

Two other studies presented at the World Congress of Pain reviews the impact of prevalence of pain worldwide and the social, economic and governmental barriers to pain management in Europe. They are both summarized in 20% Around the World Suffer from Chronic Pain yet there are Still Barriers to Adequate Pain Relief. The worldwide and European trends addressed in these studies are fascinating.