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Why So Many Migraine Patients Get Treated in the ER

People experiencing migraine attacks commonly report to the emergency room for treatment. But ERs seldom offer patients the most suitable treatment. So why go there? 

New findings presented by Dawn Buse, PhD, at the recent Annual Scientific Meeting of the American Headache Society shed new light on the issue. As Buse explained, an analysis of 2.1 million cases of people with migraine suggests that an inability to access migraine treatment may ultimately lead patients to seek care at the ER as a last resort.    

Limited access to appropriate migraine treatment leads to ER visits.  

People living with migraine often end up at the ER because they cannot access more appropriate avenues of treatment. Preventive care, including prescribed medications, is not accessible to everyone, Dr. Buse’s analysis shows. 

Access to migraine treatment varies widely according to socioeconomic background, race and ethnicity. Barriers to primary care exist in these communities, but migraine diagnosis and treatment may be especially difficult to access, according to Dr. Buse’s analysis. Barriers may include cost, geographic access, a lack of health insurance or lack of awareness about available treatments. 

 Black and Hispanic patients face higher rates of medication rejection. 

Previous research has indicated that migraine in Black Americans may be more frequent, more severe and more likely to become chronic than in non-Hispanic whites. These factors can significantly impact patients’ quality of life. Migraine can contribute to depression, lead to more missed work and raise patients’ yearly medical costs. 

Dr. Buse’s analysis revealed that Black patients with migraine were more likely than other patients to have their medication claims rejected by their health plan. Hispanic patients were also turned away more often than their white peers.  

People whose claims for prescription migraine medication had been rejected were more likely to land in the ER, Dr. Buse’s analysis showed. Black and Hispanic patients were more likely than white patients to depend on ER care for migraine-related reasons. 

ERs are not where migraine should be treated. Investing in affordable access to migraine treatment contributes to a better quality of life for patients, wiser use of medical resources, and stronger community health.  

These new findings can be a guide for policy solutions that help more people with migraine to access appropriate treatment. 

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