Factors influencing migraineur-consulting behavior in a university population

The purpose of this study was to identify factors that contribute to treatment-seeking behavior in migraineurs in a large employer population. Specifically, the impact of psychographic variables, such as social support, attitudes toward medication, locus of control, and migraine-associated disability, are considered concomitantly with demographic and disease severity variables.

Migraine remains an underconsulted condition. Previous explorations of demographic factors and headache characteristics have not adequately predicted migraineur physician-consulting behavior.

University employees and students experiencing headaches were interviewed by pharmacists to determine whether they suffer from migraine using the International Headache Society (IHS) criteria for migraine. Identified migraineurs were categorized into 3 groups: (1) never-consulter, (2) lapsed-consulter, and (3) current-consulter. Each group was asked to complete an instrument that assesses perceived social support (Headache Social Support Questionnaire), medication attitudes (Beliefs about Medicines Questionnaire), locus of control (Headache-Specific Locus of Control Scale), and migraine-associated disability (Migraine Disability Assessment Questionnaire). Univariate (ANOVA) and multivariate (logistic regression) approaches were used to identify factors associated with migraineur-consulting behavior.

A total of 100 subjects participated in the study. Eighty-two participants met IHS criteria for migraine, of whom 22 were never-consulters, 20 were lapsed-consulters, and 40 were current-consulters. The consulter groups differed on scores acquired from the Social Support Active Involvement subscale (P= .04) and the Healthcare Professional Locus of Control subscale (P= .010). The logistic regression procedures confirmed the contributions of social support and healthcare locus of control in predicting migraineur-consulting behavior.

Results suggest that attitudes concerning the role of healthcare professionals and the presence of a supportive social network have greater influence on migraineur-consulting behavior than do patient demographic characteristics, beliefs about medications, and migraine frequency and severity. With an understanding of the link between psychosocial variables and consulting behavior, healthcare professionals may be able to positively impact migraineur physician consultation rates, drug therapy, and quality of life.