Expert opinion: what causes migraine: which physician explanation do patients prefer and understand?

Although "What causes migraine," is one of the most common questions migraineurs ask their physicians, little is known about what response physicians provide, whether migraineurs believe it is important that they be provided information, or which explanation is most informative.

Seven migraine specialists were personally contacted and a convenience sample of 23 neurologists were surveyed at a meeting to obtain a range of explanations. Four explanations were selected and edited. One hundred consecutive patients seen in a general neurology practice participated in the study.

The mean response on a 5-point Likert scale to the statement, "It is important to provide patients an explanation of what causes migraine," of 15 neurologists surveyed at a meeting was 4.3 (5 = strongly agree). One hundred consecutive patients participated in the study with a mean age of 39.1 years and 87 females. The mean response to the question, "How important is it for a physician to provide you with an explanation of what causes migraine?" was 4.7 on a 5-point Likert scale (5 = very important). The explanation preferred by most (56) of the subjects was the longest (245 words) with the fewest (4) choosing the briefest (25 words).

This study suggests that neurologists and migraineurs believe that it is very important for a physician to provide them with an explanation of what causes migraine. An explanation that may be most informative may contain information in lay terms about the pathophysiology and the many triggers. The physician can provide explanations verbally, through handouts, or by referral to internet sites. Better patient understanding of what causes migraine may improve treatment adherence and patient satisfaction.