Complementary and Alternative Medicine Use Among Adults With Migraines/Severe Headaches

Rebecca Erwin Wells, MD, MPH; Suzanne M. Bertisch, MD, MPH; Catherine Buettner, MD, MPH; Russell S. Phillips, MD; Ellen P. McCarthy, PhD, MPH

Disclosures

Headache. 2011;51(7):1087–1097 

In This Article

Abstract and Introduction

Abstract

Objective.— Our objective was to determine patterns, reasons for, and correlates of complementary and alternative medicine (CAM) use by US adults with migraines/severe headaches.
Background.— While many patients with chronic conditions use CAM, little is known about CAM use by adults with migraines/severe headaches.
Methods.— We compared CAM use between adults with and without self-reported migraines/severe headaches using the 2007 National Health Interview Survey (n = 23,393), a national cross-sectional survey.
Results.— Adults with migraines/severe headaches used CAM more frequently than those without (49.5% vs 33.9%, P < .0001); differences persisted after adjustment (adjusted odds ratio = 1.29, 95% confidence interval [1.15, 1.45]). Mind–body therapies (eg, deep breathing exercises, meditation, yoga) were used most commonly. More than 50% of adults with migraines/severe headaches reporting CAM use had not discussed it with their health care provider. Nonetheless, those with migraines/severe headaches used CAM more often than those without because of provider recommendation and because conventional treatments were perceived as ineffective or too costly. Correlates of CAM use among adults with migraines/severe headaches included anxiety, joint or low back pain, alcohol use, higher education, and living in the western USA. Only 4.5% of adults with migraines/severe headaches reported using CAM to specifically treat their migraines/severe headaches.
Conclusions.— CAM is used more often among adults with migraines/severe headaches than those without. However, few report using CAM to specifically treat migraines/severe headaches. Mind–body therapies are used most frequently. Further research is needed to understand the effectiveness and mechanisms of CAM treatments in adults with migraines/severe headaches.

Introduction

Migraine headaches afflict 13% of the US population.[1] The personal and societal burden is enormous, affecting quality of life[2,3] and costing the USA $11 billion annually.[4] Despite available conventional treatments, many patients with migraines fail to achieve optimal control or have unacceptable medication side effects.

Complementary and alternative medicine (CAM) includes both complementary therapies used as an addition to conventional treatments and alternative treatments used instead of conventional therapies, although adults with migraines rarely use only alternative treatments.[5] The National Institutes of Health defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered conventional medicine.[6] A prior national survey showed that adults with headaches judged CAM therapies to be more helpful than conventional care for treatment of headaches.[7] Previously, we reported that adults with common neurological conditions used CAM more frequently than those without (44.1 vs 32.6%, P < .0001).[8] However, little is known about the patterns of CAM use in adults with migraines. Only a few prior surveys have examined CAM use in patients with headaches, and most were conducted in outpatient headache centers with small samples.[5,9–14] Knowing the prevalence and patterns of use of CAM in adults with migraines will help to characterize areas of potential underuse and barriers to use, as well as potential risks of CAM therapies in adults with migraines. Further, recognizing discrepancies between the scientific evidence and the prevalence of CAM use for patients with migraines may aid in our understanding of the medical and psychosocial needs of patients with migraines and target future areas of research. In this context, we analyzed the 2007 National Health Interview Survey (NHIS) to examine the patterns of CAM use in adults with migraines/severe headaches in the USA. We describe the types of CAM therapies used by adults with migraines/severe headaches, and explore their reasons for use, disclosure to health care providers, and correlates of CAM use.

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