PMID- 29878343
DCOM- 20190701
LR  - 20190701
IS  - 1526-4610 (Electronic)
IS  - 0017-8748 (Linking)
VI  - 58
IP  - 5
DP  - 2018 May
TI  - Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: 
      A Narrative Review, Part 2.
PG  - 633-647
LID - 10.1111/head.13321 [doi]
AB  - OBJECTIVE: To review the challenges and potential solutions in treatment options 
      for quality migraine care in adult patients who are under or uninsured.
      BACKGROUND: The Affordable Care Act has improved access to health care for many; 
      however, those who are underserved continue to face treatment disparities and
      have inadequate access to appropriate migraine management. METHODS: This
      manuscript is the second of a 2-part narrative review which was performed after a
      series of discussions within the Underserved Populations in Headache Medicine
      Special Interest Section meetings of the American Headache Society. Literature
      was reviewed for key concepts underpinning conceptual boundaries and a broad
      overview of the subject matter. Published guidelines, state-specific Medicaid
      websites, headache quality measurement sets, literature review, and expert
      opinion were used to tailor suggested treatment options and therapeutic
      strategies. In this second part of our narrative review, we explored migraine
      care strategies and considerations for underserved and vulnerable adult
      populations with migraine. RESULTS: Although common, migraine remains untreated, 
      particularly among those of low socioeconomic status. Low socioeconomic status
      may play an important role in the disease progression, prescription of hazardous 
      medications such as opioids, outcomes, and quality of life of patients with
      migraine and other headache disorders. There are some evidence-based and
      guideline supported treatment options available at low cost that include
      prescription medications and supplements, though approved devices are costly.
      Resources available online and simple nonpharmacological strategies may be
      particularly useful in the underserved migraine population. CONCLUSIONS: We
      identified and discussed migraine treatment barriers that affect underserved
      populations in the US and summarized practical, cost-effective strategies to
      surmount them. However, more research is needed to identify the best
      cost-effective measures for migraine management in underserved and vulnerable
      patients who are uninsured or underinsured.
CI  - (c) 2018 American Headache Society.
FAU - Charleston, Larry 4th
AU  - Charleston L 4th
AD  - Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
FAU - Royce, Jeffrey
AU  - Royce J
AD  - Neuro and Headache Center, SwedishAmerican Hospital, Rockford, IL, USA.
FAU - Monteith, Teshamae S
AU  - Monteith TS
AD  - Department of Neurology-Headache Division, University of Miami, Miller School of 
      Medicine, Miami, FL, USA.
FAU - Broner, Susan W
AU  - Broner SW
AD  - Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell
      Medical College, New York, NY, USA.
FAU - O'Brien, Hope L
AU  - O'Brien HL
AD  - Division of Neurology, Cincinnati Children's Medical Center, University of
      Cincinnati College of Medicine, Cincinnati, OH, USA.
FAU - Manrriquez, Salvador L
AU  - Manrriquez SL
AD  - Herman Ostrow School of Dentistry, University of Southern California, Los
      Angeles, CA, USA.
FAU - Robbins, Matthew S
AU  - Robbins MS
AD  - Department of Neurology, Albert Einstein College of Medicine, Montefiore Headache
      Center, Bronx, NY, USA.
CN  - Underserved Populations in Headache Medicine Special Interest Section of the
      American Headache Society
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Headache
JT  - Headache
JID - 2985091R
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Insurance, Health
MH  - *Medically Uninsured
MH  - Migraine Disorders/*drug therapy/*economics
MH  - United States
OT  - headache
OT  - health disparities
OT  - migraine
OT  - treatments
OT  - underinsured
OT  - underserved
OT  - uninsured
EDAT- 2018/06/08 06:00
MHDA- 2019/07/02 06:00
CRDT- 2018/06/08 06:00
PHST- 2017/10/25 00:00 [received]
PHST- 2018/02/21 00:00 [revised]
PHST- 2018/02/22 00:00 [accepted]
PHST- 2018/06/08 06:00 [entrez]
PHST- 2018/06/08 06:00 [pubmed]
PHST- 2019/07/02 06:00 [medline]
AID - 10.1111/head.13321 [doi]
PST - ppublish
SO  - Headache. 2018 May;58(5):633-647. doi: 10.1111/head.13321.