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The evolution of migraine care at the time of COVID-19: learnings from the pandemic

The COVID-19 pandemic has impacted the lives of many people around the world. To protect ourselves and those around us from the virus, we have urgently had to change the way we interact and work with each other, our daily routines and how we function in our respective communities.

In today’s blog, Elena Ruiz de la Torre, Executive Director of the European Migraine and Headache Alliance, and Simona Sacco, Professor of Neurology at the University of L’Aquila, Italy, explore how the migraine community’s responses to these challenges – harnessing innovative technologies, streamlining prescription delivery and flexible working – could potentially influence the evolution of migraine care and policies in the future.

Q. Ms Ruiz de la Torre, how do you feel the COVID-19 pandemic has impacted the lives of those with migraine?

For those who live with migraine, emotional stress can be a trigger for more frequent and intense attacks. Drastic changes in daily routine and diet, and the inability to exercise, can also cause distress that in turn triggers pain.

Due to the imposed mobility restrictions and suspension of some headache clinics and medical appointments, migraine patients have faced difficulties in consulting their doctors, collecting their medication and even in access to emergency care. These restrictions may also be jeopardizing the number of patients remaining on the pathway to optimal care. In response, some headache specialists and hospitals have adapted to provide remote consultations and deliveries of medication directly to patients’ homes or close-by pharmacies, so patients can continue to access migraine care when they need it most. However, not all European countries have been able to do so.

During these times of need, our priority as a patient organization is to keep patients up-to- date with the latest information and equip them to be able to manage their condition from home. With support from the scientific community, we have been able to provide this essential service to migraine patients.

Patient groups, the scientific community and those who make key healthcare decisions should continue to collaborate to ensure migraine patients can receive the optimal care and support they deserve now, and in the future, whatever the circumstance.

Q. Professor Sacco, how have headache specialists reacted to the restrictions imposed by the pandemic and how has technology come into play?

In-person visits will always have an important role in the relationships between us doctors and our patients, but during this crisis we have had to quickly learn and adopt new and existing technologies to continue to care for our patients. In fact, some of these technologies have proven to be very effective.

With face-to-face appointments for non-urgent medical matters prohibited, headache specialists and patients are becoming more familiar with virtual or over-the-phone consultations. Tele-health is invaluable. It allows us to continue caring for people living with migraine and reduce emergency room visits, which put patients at elevated risk of COVID-19 and can place additional burdens on already overwhelmed healthcare systems.

To further protect patients, the public and healthcare systems, some clinics are also arranging for prescription treatments to be delivered to patients directly or to pharmacies closer-by to them, limiting the need for them to travel far.

We have been able to rapidly adapt to a different way of providing healthcare to our patients. I hope healthcare providers and decision makers in the migraine space join me in reflecting on the sustainable solutions that we have implemented: let’s collaborate to ensure these can be part of routine clinical practice to continue to optimize migraine care in the future.

Q. Ms Ruiz de la Torre, how is technology enhancing the lives of migraine patients?

In my view, technology can help migraine patients in many ways. Professor Sacco is right in that tele-health could be utilized to extend medical services and improve efficiency in the future, particularly when patients are located far and wide and can’t get to medical centers easily.

Technology is also playing an integral role in the lives of those who have had to adapt to smart working. Some migraine patients may be experiencing improved work productivity at home, as they are able to better control their environment for lighting and noise, and work flexible hours if they experience a migraine attack. They may also be less stressed due to avoiding public transport and traffic, and by having more control over their own time.

Any positive insights into the productivity of employees living with migraine might have the potential to break down some of the barriers that may exist between them and their employers. I hope this can help patients return to a workplace that better understands their needs.

More can be done by key decision makers to create infrastructures and policies that encourage the use of tele-health in future migraine care, as well as the wider adoption of smart working to meet the needs of people with migraine in the workplace.

From challenge to opportunity: Ms Ruiz de la Torre and Professor Sacco’s plea for positive change

Migraine patients may be suffering in many ways due to COVID-19, but there is much that we can learn in these demanding times. Harnessing innovative technologies, streamlining prescription delivery and exploring flexible working can help us see the upside of a challenging situation and promote a positive evolution in migraine care for the future. So, while we look forward to life post-COVID-19, we encourage the migraine community, healthcare services and employers to turn these learnings into long-lasting positive changes for tomorrow’s migraine care.

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