Of more than 500 people recently surveyed by Migraine Foundation Aotearoa New Zealand, nearly half reported not being able to see a health professional.
About half couldn’t access a neurologist, while more than a quarter struggled to even find treatment through a GP, with respondents citing cost, long wait times or simply having appointments declined.
The new study’s lead author, University of Otago senior researcher Dr Fiona Imlach, said most people with migraine disease could be managed in primary care.
“But people can’t always see their GP when they need to.”
There were many other patients living with chronic migraine who’d likely benefit from specialist reviews – yet couldn’t be seen through the public system.
“Their only option is to go private, if they can afford it,” Imlach said.
On top of those issues, more than 40 per cent of respondents reported feeling judged or misunderstood by clinicians.
“Because the diagnosis of migraine is based on symptoms reported by the patient . . . people don’t always feel like their levels of pain and disability are taken seriously or believed, or they’re told they have a mental health issue,” Imlach said.
“They end up not getting adequate treatment or even a proper diagnosis.”
One survey respondent reported not being able to get a diagnosis with migraine disease until seeing a different doctor, eight years after her symptoms began.
She wasn’t prescribed migraine-specific medication until a protracted attack landed her in the emergency department and she spoke of being made to feel like “a dramatic teenage girl” who was “sensitive to pain”.
One took a male friend suffering a migraine to the emergency department, where he was given pain medication after x-ray scans.
“Every woman I’ve taken has been given a [prescription] for paracetamol and sent on their way home to discuss with GP.”
The findings further highlighted misunderstanding among health professionals, with just a third of respondents rating their GP’s knowledge of migraine and treatment as excellent or very good.
Some thought their doctors didn’t always understand that a migraine was more than just a headache – and awareness of new treatment plans was often limited.
Imlach said that, aside from better investment in the health system, there was a range of measures that could improve things.
“Specifically for migraine, we need to make sure there is up-to-date, comprehensive and standardised training about migraine for all health professionals involved in the management of migraine patients,” she said.
“We need to have better communication about treatment plans between primary and secondary care and give patients all the information and tools they need to manage their condition effectively.
“This includes access to a wider range of migraine medications, which are not yet available or funded in New Zealand.”
Health New Zealand’s primary care group manager, Astuti Balram, acknowledged the current funding system for general practice had “limitations” that affected access.
Some steps have been taken, including a 5 per cent funding increase for all primary and community health services, and a review now under way.
Health NZ had also commissioned primary care guidance “pathways” for headaches, which included migraine.
Wilson-Whiting, meanwhile, said it’d at least be good to see migraine formally recognised as a disability – something researchers say would help sufferers access benefits and support at work.
“There are so many people suffering from migraine in this country - and we need to prioritise resources for treatment and care.”
Jamie Morton is a specialist in science and environmental reporting. He joined the Herald in 2011 and writes about everything from conservation and climate change to natural hazards and new technology.
