Migraine management among Black older patients requires multidisciplinary interventions and coordinated efforts among emergency medicine clinicians, primary care clinicians, and neurologists/neurology PAs, according to study findings reported in a poster session at the American Association of Physician Assistants (AAPA 2022) conference held May 21 to May 25, 2022, in Indianapolis.
Migraine is a common chronic condition that remains underdiagnosed and is associated with worse outcomes among underrepresented individuals. The study authors sought to examine the clinical correlates of migraine headaches in a sample of underserved Black older adults.
The sample included 740 Black older adults (aged 55 years and older; 64% women) from senior centers, senior housing centers, faith-based organizations, and apartment complexes in South Los Angeles. Participants provided demographic information, were asked “Have you ever been diagnosed with migraines by a health care provider?”, and completed the following tools: Short-Form McGill Pain Questionnaire, Geriatric Depression Scale, Self-rated Health Status, Health-Related Quality of Life Survey.
Of the 740 respondents, 343 (46%) reported having been diagnosed with migraine. Of the overall group, the prevalence of migraine was higher among women (21%) than men (15%). Migraines were associated with the following 3 outcomes:
- Higher level of health care utilization as measured by:
- Emergency department admissions
- Number of medications used
- Lower level of health-related quality of life and health status as measured by:
- Physical quality of life
- Mental quality of life
- Lower self-rated health
- Worse physical and mental health outcomes as measured by:
- Higher number of depressive symptoms
- Higher level of pain
- Sleep disorder
- Level of disability
Participants with migraines were more likely to report prescription drug use compared with those who did not report migraines. Additionally, associations were found between migraine and chronic pain, depression, and sleep disorders in this cohort.
The findings show a much higher prevalence of migraine in Black older adults than in the general population, the study authors stated. The findings are consistent with current knowledge on the lack of physician access, prohibitive costs, and substandard migraine therapy in underserved patients, they said.
“PAs are well poised to address the current gaps that may result in migraineurs seeking treatment in overcrowded [emergency departments] and to reduce race-related disparities associated with migraine identification and treatment in African American patients,” the study authors concluded.
Comini J, Kibe L W, Cobb S, Assari S, Bazargan M. Migraine headache among underserved African American older adults. Poster presented at: AAPA 2022; May 21-25, 2022; Indianapolis, IN.