Magazine article Clinical Psychiatry News

Better Patient Interviews May Aid Migraine Treatment

Magazine article Clinical Psychiatry News

Better Patient Interviews May Aid Migraine Treatment

Article excerpt

SCOTTSDALE, ARIZ. -- Open-ended questions during patient interviews elicit the best information for guiding the management of patients with migraine headache, Dr. Richard B. Lipton said at a symposium sponsored by the American Headache Society.

Yet closed-end questions focusing on headache triggers, frequency, and symptoms comprised most of the dialogue between physicians and migraine headache patients, based on the American Migraine Communications Study (AMCS). And the patient and physician often differed in their assessments of headache frequency, disability, and impairment, said Dr. Lipton, who is professor of neurology at the Albert Einstein College of Medicine, New York.

Patients and physicians really weren't hearing and understanding each other during the office visit, he said. As a result of these miscommunications, physicians underappreciated the need for preventive treatment and patients had incomplete knowledge about medication use and inappropriate expectations of their outcomes.

The AMCS findings were based on analyses of videotaped encounters with 60 patients (80% women, mean age 42 years) and a geographically representative sample of 14 primary care physicians and 8 neurologists. The average duration of migraines was 14 years with a frequency of five episodes per month.

Dr. Lipton and his coinvestigator Dr. Steven R. Hahn analyzed the structure of questions posed during the recorded physician-patient interviews. Closed-ended questions allowed patients to make selections, while open-ended questions encouraged more wide-ranging dialogue. …

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