Patterns of healthcare utilization for migraine in the United States: Results from the All of Us Research Program

Editor’s note: The research described below comes from a recipient of a 2024 MSC Travel Grant supporting travel to the 66th Annual Scientific Meeting of the American Headache Society. These grants reimburse travel expenses for those who have had their abstract for a presentation or poster accepted at a meeting.

By Idris Demirsoy, PhD, postdoctoral researcher, University of California Irvine, US

What is the research gap that your study addresses?

The study addresses a research gap concerning healthcare utilization patterns among individuals with migraine, particularly focusing on sex and racial differences in All of Us research. Its aim is to include data from 1 million participants and especially to focus on underrepresented groups. Based on our knowledge we are the first ones using this database to evaluate participants with migraine for health care utilization.

What is your research hypothesis?

Whether or not there are significant differences in healthcare utilization patterns among individuals with migraine, with variations based on sex and race, including differences in employment, income, frequency of healthcare provider visits, and delay in seeking medical care.

What methodology did you use to address your research hypothesis?

The study utilized a cross-sectional design and a secondary analysis from the All of Us Research Program. It included individuals who self-reported migraine and completed the “Health Care Access & Utilization” survey. We had one of the largest cohorts of migraine participants with a sample size of 14,992. Descriptive statistics and appropriate statistical tests were used to analyze healthcare utilization patterns, employment status, household income, frequency of healthcare provider visits, type of healthcare visits, delay in seeking medical care, reasons for delaying care, and medication affordability. Comparisons based on sex and race were conducted to address the research hypothesis regarding disparities in healthcare utilization patterns among individuals with migraine.

What are the main results of your study?

Females with migraine were more likely to delay medical care than males. Blacks with migraine had more frequent doctor visits and were more likely to use emergency rooms than non-Hispanic whites. Affordability was a major reason for delaying care among both sexes, with females more likely to struggle affording medications. There wasn’t a significant difference in overall healthcare provider visits between males and females. Females had a higher employment rate, but lower household income compared to males.

What conclusions did you reach based on your results?

This study on healthcare utilization among migraine sufferers found sex and racial disparities. Females delay care more often and Blacks have more doctor visits and emergency room use, which indicates a need for targeted interventions to address these disparities. Affordability is a major barrier for both sexes.

What are the limitations of your study?

The study relies on self-reported data, which can be inaccurate. The sample may not represent all migraine sufferers, and the design can’t provide details of why sex or race influences healthcare use. Finally, the study focuses on reported reasons for delayed care, potentially missing other factors. Language barriers, education level and geographical location might have an effect as well. Furthermore, while the study identified disparities, it did not delve into the underlying causes of these disparities or the effectiveness of potential interventions to address them.

What is the relevance of your study to migraine?

This study highlights unequal healthcare access among migraine sufferers. Females delay care more often, and Black individuals utilize emergency rooms more compared to white counterparts. By highlighting disparities in employment, income, healthcare access, and medication affordability, the study underscores the need for targeted interventions to address them. These findings are relevant to migraine because unequal access to preventive care and treatment can worsen migraine symptoms and quality of life. Understanding these disparities can inform efforts to improve healthcare access for migraine sufferers.