The care demand from dieticians regarding the treatment of migraine is high and there is a clear need for evidence-based knowledge development and treatment options. This has emerged from research by Miriam de Lange, dietician in training, for the knowledge platform Pacea.
Relationship between diet and migraines
One of the lifestyle factors that can contribute to the improvement of migraine is diet. Several studies have reported an association between dietary triggers and migraines. However, there is no guideline for dietitians on how to treat people with migraine. That is why De Lange conducted a needs assessment into the question from dieticians about migraine. The aim is to use the results to develop knowledge for dieticians, in order to provide people with migraine with the right guidance in the possible improvement of lifestyle factors such as nutrition.
Results needs assessment
The research that De Lange conducted is a descriptive, quantitative and partly qualitative study in the form of an online survey, in which 144 dieticians participated. This has shown that dietitians use very different dietary interventions and that treatment is based on both scientific and empirical evidence. A small proportion (21 percent) refer clients to healthcare professionals such as doctors, general practitioners, naturopaths, allergy specialists or orthomolecular dieticians. The majority of dietitians surveyed (79 percent) treat people with migraines themselves.
The majority (78 percent) of all dieticians surveyed do not feel competent enough to treat people with migraines. Of the group of dietitians who already treat people with migraine, almost three-quarters (70 percent) say they do not feel competent to treat people with migraine.
Almost all dieticians surveyed (96 percent) indicate a greater need for evidence-based knowledge in migraine. In addition, they say they find it valuable to be able to treat people with migraine themselves; they give this an average rating of 4.4 points on a scale of 1 to 5. In addition, the research has shown that in practice migraine is never treated as the main complaint, but is seen as a comorbidity and that migraine is not always included in the treatment.
As a follow-up to this research, De Lange wants to develop and implement a flowchart for dietitians. The flowchart will provide insight into which treatment options within dietetics can provide optimal lifestyle treatment for migraine. This will enable dieticians to better fulfill their role within this patient category and create more uniformity of treatment within the professional group. By providing insight into the other lifestyle factors that can influence migraine, such as stress, exercise and sleep, they also get a better overview of the importance of a possible interdisciplinary approach. Furthermore, it will provide the dietician with tools to properly map out and follow up the severity, duration and complaints surrounding migraine, in order to better map out the effect of treatment.
Migraine is a chronic disabling brain disease with a high societal impact, in which medication is used to reduce the frequency and severity of migraine attacks. Yet there is increasing scientific evidence that migraine can also be improved with non-drug treatments, such as lifestyle adjustments. Because many people with migraine have insufficient knowledge of lifestyle factors that can be relevant to improve migraine, Wardell America, neurologist in training, founded the scientific knowledge platform Pacea in 2018. Pacea’s mission is to guide people to find the right lifestyle that can improve their migraines.