Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2022; 12(5): 414-427
Published online Sep 20, 2022. doi: 10.5662/wjm.v12.i5.414
Migraine in physicians and final year medical students: A cross-sectional insight into prevalence, self-awareness, and knowledge from Pakistan
Hassan Choudry, Fateen Ata, Muhammad Naveed Naveed Alam, Ruqaiya Ruqaiya, Mahammed Khan Suheb, Muhammad Qaiser Ikram, Muhammad Muzammil Chouhdry, Muaz Muaz
Hassan Choudry, Department of Respiratory Medicine, University Hospital of Leicester, Leicester LE1, United Kingdom
Fateen Ata, Department of Internal Medicine, Hamad Medical Corporation, Doha 0000, Qatar
Muhammad Naveed Naveed Alam, Ruqaiya Ruqaiya, Muhammad Qaiser Ikram, Muhammad Muzammil Chouhdry, Muaz Muaz, Department of Neurology, Faisalabad Medical University, Faisalabad 38000, Punjab, Pakistan
Mahammed Khan Suheb, Department of Neurocritical Care, Adventhealth, Orlando, Florida 33662, United States
Author contributions: Choudry H, Ata F and Naveed Alam M were responsible for study design; Choudry H, Ata F, Naveed Alam M, Ruqaiya R and Qaiser Ikram M did the questionnaire design; Choudry H and Naveed Alam M analyzed the data; Choudry H and Ata F were responsible for the manuscript revision; all authors participated in data collection and manuscript writing.
Institutional review board statement: The study was conducted following the guidelines of the Declaration of Helsinki and approved by the institutional ethical review committee of the Faisalabad Medical University (No. 000319). The ethics committee waived informed consent.
Informed consent statement: Informed consent from patients was waived by the ethics committee.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Data sharing statement: Data can be made available from the first or corresponding author at reasonable request
STROBE statement: The authors have read the STROBE checklist of items, and the manuscript was prepared and revised according to the STROBE checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fateen Ata, BSc, MBBS, MD, Doctor, Department of Internal Medicine, Hamad Medical Corporation, PO Box 3050, Hamad General Hospital, Hamad Medical Corporation, Doha 0000, Qatar. docfateenata@gmail.com
Received: April 28, 2022
Peer-review started: April 28, 2022
First decision: June 8, 2022
Revised: June 22, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 20, 2022
Processing time: 141 Days and 0.2 Hours
ARTICLE HIGHLIGHTS
Research background

Despite its high prevalence, migraine remains underdiagnosed worldwide. A significant reason is the knowledge gap in physicians regarding diagnostic criteria, clinical features, and other clinical aspects of migraine.

Research motivation

This research was conducted to see whether migraine follows the same trends of underdiagnosis in Physicians of Pakistan as globally.

Research objectives

We aimed to measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.

Research methods

An online questionnaire was developed and distributed among physicians and final-year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals, Faisalabad, between October 2018 and October 2019. Inclusion criteria were public practicing physicians who experience headaches, while those who never experienced headaches were excluded. Different questions assessed respondents on their knowledge of triggers, diagnosis, management, and prophylaxis of the migraine headache. They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine. Graphs, tables and figures were made using Microsoft Office 2016 and Microsoft Visio, and data analysis was done in R Studio 1.4.

Research results

We had 213 respondents and 175 fulfilled inclusion criteria, with 99 (52%), 58 (30%) and 12 (6.3%) belonging to specialties of medicine, surgery, and others, respectively. Both genders were symmetrically represented (88 male and 87 female). Fifty-two (24.4%) of our 213 respondents were diagnosed with migraine, with 26 (50%) being aware of it. Females had higher prevalence among study participants (n = 28, 32.2%) compared to males (n = 20, 22.7%, P = 0.19). A majority (62%) of subjects never consulted any physician for their headache. Similarly, a majority (62%) either never heard or did not remember the diagnostic criteria of migraine, and 38% falsely believed that having any type of aura was essential for diagnosing migraine. The consultation rate was 37% (n = 65), and migraineurs were significantly more likely to have consulted a physician, a neurologist in particular (P < 0.001). Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts. There was no significant difference in other knowledge aspects between consulters and non-consulters and migraineurs and non-migraineurs.

Research conclusions

Critical knowledge gaps exist between physicians and medical students, potentially contributing to the misdiagnosis and mismanagement of migraine cases.

Research perspectives

Migraine remains an underdiagnosed disease in the general population as well as among healthcare providers. Education, timely diagnosis, and management will help reduce its global burden.