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The results of a data analysis – there’s a lot to improve in the treatment of migraine patients 

A unique study on the treatment results of migraine patients led Terveystalo to develop the treatment of migraine patients. The goal is that patients get treatment earlier and receive more effective treatment. 

Migraine should be diagnosed in occupational health care much, much earlier than at present, Terveystalo neurology specialist Markku Nissilä says.

Nissilä bases his comments on the results, which were obtained from internationally unique material, i.e. the register data of 17,623 migraine patients of Terveystalo occupational health care. All patients had given permission to store their data in Terveystalo’s database for research use.

“A similar data source has not been used in previous migraine studies. What made the data unique was that we were able to combine information on the patients’ use of health services and the number of sick days.”

Up to 700,000 people suffer from migraine in Finland. The results of a study carried out in collaboration between Medaffcon, Novartis and Terveystalo showed that migraine patients use 1.7 times more healthcare resources than others and have twice as many sickness absences as others. This means big costs for society and companies, as well as a decrease in the quality of life for migraine patients. The cost of one sick day to the employer is 300 euros on average.

“The results were a real wake-up call for me and gave me the guts to work on improving migraine diagnosis and the treatment chain,” says Nissilä.

On the basis of the data, it was easy for Nissilä to show Terveystalo’s management that the treatment of migraine patients should be developed. The results help to justify a more effective way of treating migraine also for occupational health care customer companies, because the number of sickness absences caused by migraine is so high.

Migraine often goes undiagnosed

This study included already diagnosed migraine patients, but according to previous studies, up to half of migraine patients are undiagnosed, about 250,000 people in Finland.

“I am very concerned about undiagnosed migraine patients. There are a lot of so-called hidden migraines, and they are often treated as muscle tension headaches, for example with the help of physiotherapy.”

Terveystalo will start a training on migraine diagnostics and treatment in the next few weeks. The online training is aimed especially for occupational health nurses.

“Personal notifications of absence come to the nurses. That’s why they are in an essential position. As soon as there are several days of absence, you should find out if the cause is migraine. Migraine should be recognized much earlier than currently, and it should be diagnosed already after the second attack.”

Migraine is also interesting from the point of view of Terveystalo’s Etydi system. In the system, the doctor can in the future compare the treatment results of his own patients with the results of the patients of his unit and the entire Terveystalo.

In addition, a headache diary is being added to Terveystalo’s new patient information system. From the diary, the doctor can see how many symptoms the patient has had and can use it to monitor the effectiveness of the treatment. The headache diary helps to improve the quality of care and monitoring. With it, for example, the selection of the right drug option becomes more effective.

“Unfortunately, in the treatment of migraine, we continue to use standard painkillers, even though they are not effective enough. During a migraine attack, the patient should be able to function within a couple of hours with the help of medication,” says Nissilä.

An important finding in the study was the connection between anti-migraine drugs and depression. The more courses of anti-migraine medication the patient has had, the more often he also has depression.

“The result shows that migraine should be better controlled. We are about to start a clinical drug trial, which will monitor the effectiveness of biological migraine medicine in the treatment of migraine and depression.”

In Nissilä’s opinion, the visualization of the study was very enlightening. It brought a completely new perspective to the data, which cannot be seen from tabular data.

”It is really valuable that, thanks to visualization, you can see what other diseases are often associated with migraine. It enables you to treat secondary diagnoses effectively and, if necessary, guide the patient forward. Such visualizations strengthen medical sophistication and would also be valuable in medical education”, says Nissilä.

This text was written based on an interview with Terveystalo neurology specialist Markku Nissilä and translated from the original Finnish text.

Read more:

Burden of migraine in Finland: health care resource use, sick-leaves and comorbidities in occupational health care. Korolainen MA, Kurki S, Lassenius MI, Toppila I, Costa-Scharplatz M, Purmonen T, Nissilä M. Accepted 27.1.2019: Journal of headache and pain, DOI 10.1186/s10194-019-0964-5. 

Burden of migraine in Finland: multimorbidity and phenotypic disease networks in occupational healthcare, Korolainen MA, Tuominen S, Kurki S, Lassenius MI, Toppila I, Purmonen T, Santaholma J ja Nissilä M. The Journal of Headache and Pain (2020) 21:8. DOI: 10.1186/s10194-020-1077-x.

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