Published online Sep 20, 2022. doi: 10.5662/wjm.v12.i5.414
Peer-review started: April 28, 2022
First decision: June 8, 2022
Revised: June 22, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 20, 2022
Processing time: 141 Days and 0.2 Hours
Despite its high prevalence, migraine remains underdiagnosed worldwide. A significant reason is the knowledge gap in physicians regarding diagnostic criteria, clinical features, and other clinical aspects of migraine.
This research was conducted to see whether migraine follows the same trends of underdiagnosis in Physicians of Pakistan as globally.
We aimed to measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.
An online questionnaire was developed and distributed among physicians and final-year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals, Faisalabad, between October 2018 and October 2019. Inclusion criteria were public practicing physicians who experience headaches, while those who never experienced headaches were excluded. Different questions assessed respondents on their knowledge of triggers, diagnosis, management, and pro
We had 213 respondents and 175 fulfilled inclusion criteria, with 99 (52%), 58 (30%) and 12 (6.3%) belonging to specialties of medicine, surgery, and others, respectively. Both genders were symmetrically represented (88 male and 87 female). Fifty-two (24.4%) of our 213 respondents were diagnosed with migraine, with 26 (50%) being aware of it. Females had higher prevalence among study participants (n = 28, 32.2%) compared to males (n = 20, 22.7%, P = 0.19). A majority (62%) of subjects never consulted any physician for their headache. Similarly, a majority (62%) either never heard or did not remember the diagnostic criteria of migraine, and 38% falsely believed that having any type of aura was essential for diagnosing migraine. The consultation rate was 37% (n = 65), and migraineurs were significantly more likely to have consulted a physician, a neurologist in particular (P < 0.001). Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts. There was no significant difference in other knowledge aspects between consulters and non-consulters and migraineurs and non-migraineurs.
Critical knowledge gaps exist between physicians and medical students, potentially contributing to the misdiagnosis and mismanagement of migraine cases.
Migraine remains an underdiagnosed disease in the general population as well as among healthcare providers. Education, timely diagnosis, and management will help reduce its global burden.