Migraine Under-Treatment Plagues Spain Despite Available Options

Despite the availability of effective treatments, migraine remains undertreated in Spain, affecting 13.1% of the population. A cross-sectional study using data from the 2022 National Health and Welfare Survey (NHWS) revealed that only 9.5% of diagnosed migraine patients receive preventive treatment, even though 24.7% experience more than four migraine days per month, a threshold where preventive treatment is generally recommended [Source: National Institutes of Health].

Alarming Discrepancy in Migraine Treatment

Dr. Jesús Porta-Etessam, Head of Neurology at the Jiménez Díaz Foundation and president of the Spanish Society of Neurology (SEN), emphasized the concerning gap in migraine care. “The percentage of patients who are receiving this treatment have grown with respect to ancient data, but we don’t have to be happy because it is still much lower than we expected, very few patients are receiving preventive treatment,” he told Medscape in Spanish.

Did You Know? Migraine is the third most prevalent illness in the world, affecting 1 in 7 people.

Expert Insights on Treatment Gaps

Dr. Roberto Belvís, coordinator of the Cephaleas Study Group of the Spanish Society of Neurology, noted the value of having current data representative of Spain, as previous data was outdated.He highlighted that approximately half of migraine patients who should be receiving preventive treatment are not, indicating a need for improved education for patients and authorities.

The study does not specify the reasons for this undertreatment. While adverse effects of older preventive medications are a known cause of low therapeutic compliance, Dr. Belvís pointed out that newer preventive treatments are specifically designed for migraine and have fewer side effects.

Shifting Treatment Paradigms

Historically, anti-inflammatories were the standard treatment for mild to moderate migraine attacks, while triptans were reserved for severe cases.though, Dr. Belvís noted that family doctors frequently enough prescribe simple analgesics and anti-inflammatories more frequently than triptans. despite being available since the 1990s, non-specialists are hesitant to prescribe triptans, particularly for adolescents, even though they can be indicated from age 12. Consequently, many adolescents receive inadequate treatment with paracetamol and anti-inflammatories rather of the triptans they need.

Pro Tip: Consult a neurologist specializing in headaches for personalized migraine treatment plans.

Economic Burden of Migraine

The study estimates the annual cost per person with migraine in Spain to be 6,704 euros.Dr. Porta-Etessam highlighted that the economic impact is primarily driven by indirect costs related to loss of productivity, emphasizing that migraine significantly impacts patients’ ability to lead normal lives.

“If we really analyze the prevalence of migraine and disability it produces, we see that it is indeed much greater than that of the new preventive treatments,” said Dr. Porta-etessam.

Stigma and misunderstanding

To improve migraine management, it is crucial to address the stigma surrounding the condition. Patients face public stigma,with negative social attitudes trivializing their condition,and also internalized stigma,where patients absorb these negative opinions. Dr. Sonia Quintas, a neurologist specializing in headaches, noted that many individuals with migraine do not seek medical help, normalizing their pain. even when they do consult, family doctors may not recognize migraine, leading to underdiagnosis and undertreatment.

Structural stigma also plays a role, with policies restricting access to care and resources.Dr. Quintas explained that healthcare professionals may belittle migraine or prescribe treatments without proper indication for preventive use. Furthermore, the healthcare system may allocate less time for migraine patients, and access to newer, more specific oral pharmacological treatments varies across autonomous communities in Spain, representing an institutionalized stigma in treatment access.

Addressing the Gender Disparity

Dr. Porta-Etessam pointed out that migraine disproportionately affects women (18% compared to 7% of men), suggesting that this gender disparity contributes to the condition being undervalued in the political arena. He emphasized the need for a national strategic plan for migraine to improve access to treatments and ensure proper care for patients.

Moving Forward

while migraine has no cure, effective treatment can significantly improve patients’ quality of life.Dr. Porta-Etessam stressed the importance of training students, residents, primary care doctors, and specialists to better manage migraine. The recent launch of the Spanish Cepaleas Foundation (FECEF) by the Spanish Society of neurology aims to promote recognition of migraine at a social and political level.

Key Migraine Statistics in Spain

What steps can be taken to reduce the stigma associated with migraine? How can healthcare systems improve access to specialized migraine care?

Disclaimer: This article provides general facts and should not be considered medical advice. Consult with a qualified healthcare professional for personalized guidance and treatment.

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