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Nonpharmacological Self-Management of Migraine Across Social Locations: An Equity-Oriented, Qualitative Analysis.
Befus, Deanna R; Hull, Sharon; Strand de Oliveira, Justine; Schmidler, Gillian Sanders; Weinberger, Morris; Coeytaux, Remy R.
Afiliación
  • Befus DR; Arthur Labatt Family School of Nursing, Western University Faculty of Health Sciences, London, Ontario, Canada.
  • Hull S; Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.
  • Strand de Oliveira J; Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.
  • Schmidler GS; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
  • Weinberger M; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
  • Coeytaux RR; Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Glob Adv Health Med ; 8: 2164956119858034, 2019.
Article en En | MEDLINE | ID: mdl-31223518
BACKGROUND: Migraine is a disabling neurological disorder and the sixth biggest cause of disability worldwide. The World Health Organization has declared migraine a major public health problem due to a paucity of knowledge about cause and effective treatment options. Both in incidence and severity, migraine disproportionately affects people occupying marginalized social locations (SL). Managed pharmacologically, migraine is treated with daily preventive and as-needed abortive medications. Both come with high literal and figurative costs: intolerable side effects, medication interactions, and prohibitive prices. Cost prohibitive, ineffective, and unsustainable pharmacological treatment options have contributed to high levels of interest in complementary approaches by people with migraine, but little is known about their motivations, patterns of use or access, or how these may vary by SL. METHOD: We conducted focus groups with 30 people with migraine to explore their desires and recommendations for migraine clinicians and researchers. We used qualitative content analysis to identify themes.Outcomes: We identified 4 themes: a more holistic, collaborative, long-term treatment approach; medication as a short-term solution; high personal and economic costs of medication; and desire for more information and access to natural approaches. Across SL, participants expressed keen interest in integrative approaches and wanted better access to complementary modalities. Participants in marginalized SL described reliance on traditional/folk remedies, including engagement with family and community healers, who they described as more affordable and culturally accessible. CONCLUSIONS: Holistic and integrative approaches were preferred over medication as long-term migraine management strategies. However, people in marginalized SL, while disproportionately disabled by migraine, did not feel as comfortable accessing integrative approaches through currently available channels. Engaging with these communities and using a critical lens to explore barriers to access can develop options to make complementary modalities more approachable, while also attending to systemic blind spots that may unintentionally alienate socially marginalized groups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Qualitative_research Aspecto: Equity_inequality Idioma: En Revista: Glob Adv Health Med Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Qualitative_research Aspecto: Equity_inequality Idioma: En Revista: Glob Adv Health Med Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos