No One-Size-Fits-All For Migraine Treatments: Survey
A survey conducted by researchers from the University of Otago, Wellington – Ōtākou Whakaihu Waka, Pōneke, has just been published in the Journal of Clinical Medicine.
The Migraine in Aotearoa New Zealand survey has examined the use of supplements and complementary therapies by people in New Zealand with migraine disease.
Participants were asked about supplements such as magnesium, riboflavin (vitamin B2) and coenzyme Q10 and complementary therapies including acupuncture, biofeedback, neuromodulation devices, meditation, yoga and massage.
Co-author Dr Fiona Imlach, Senior Research Fellow in the Department of Public Health and co-founder of the Migraine Foundation, says many people with migraine don't take medication to prevent migraine attacks, but there are non-pharmacological approaches that can help.
'No previous research has looked at the use of these approaches in Aotearoa, so it's a new finding that about half of the 530 survey respondents were currently using a supplement and even more, 58 per cent, were using complementary therapy.'
Although most non-pharmacological treatments are considered safe or low-risk, the quality of evidence for their effectiveness can be low.
The survey focused on treatments that were included in international guidelines on migraine management, including those not easily accessed in New Zealand, such as neuromodulation devices, that work by stimulating nerves in order to change the way that pain signals in the brain are processed.
However, access to neuromodulation devices is limited and costly, with previous distributors pulling out of the New Zealand market, Dr Imlach says.
'Neuromodulation devices and other therapies could be beneficial for both patients and for workplaces, by decreasing the number of days people are affected by migraine, improving quality of life and people's ability to work.
'These approaches can also be a good option for people who can't or don't want to take medication, such as during pregnancy. So even though people said they would like to try non-medication treatments as part of their migraine management plan, they can be expensive and hard to find information about.'
The survey also confirmed there is no single approach to migraine prevention that is universally effective, so people have to use trial and error.
'For all of the treatments we asked about, there were many people who had tried them but they didn't work or had side effects.
'There were also those who hadn't tried them before but wanted to. All of this speaks to the huge need for more effective migraine treatments, both medication and non-medication.
'New Zealand is lagging behind other countries with regards to funding and access to migraine-prevention medication and other therapies.'
'In addition, much more research is needed to understand the underlying pathophysiology of migraine and identify alternative treatments for those who continue to have frequent and severe migraine attacks despite trying many therapies.'
Publication details:
Use of Non-Pharmacological Approaches for Migraine Treatment: Results from the Migraine in Aotearoa New Zealand Survey
Authors: Dr Fiona Imlach, Susan Garrett
Journal of Clinical Medicine
DOI: https://doi.org/10.3390/jcm14124023
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Otago Daily Times
11 hours ago
- Otago Daily Times
Vaccines in a tablet among projects to receive research council funding
The Health Research Council of New Zealand provides millions of dollars each year, to improve the health and wellbeing of New Zealanders, by identifying and supporting high-quality, high-value research that has far-reaching impacts. John Lewis takes a look at the 18 research projects at the University of Otago, which received $15.3 million in the latest round of grants. A fear of needles has long been one of the bones of contention when it comes to getting vaccinated in New Zealand. But now University of Otago researchers hope to remove that obstacle by creating vaccines in the form of a tablet. Project leader and School of Pharmacy researcher Professor Sarah Hook said vaccines were only beneficial if everyone was willing to be vaccinated. "This is currently not the situation in Aotearoa New Zealand. "We urgently need to investigate new approaches to improve vaccine uptake and develop culturally appropriate messaging and initiatives to promote equity in vaccine access." The multi-disciplinary research team received a $1.2 million Health Research Council of New Zealand grant yesterday to create a simple, safe and effective self-administered oral vaccine in a capsule form. She said vaccination was a key public healthcare intervention which prevented the spread of infectious diseases, and more recently, it was being used to treat chronic conditions such as cancer. So initially, their research focus would be on creating an oral influenza vaccine, and a novel vaccine treatment for colon cancer. For vaccines to provide health benefits, people must have the confidence and willingness to be vaccinated, and the ability to access vaccine delivery services, she said. Alongside the lab-based research, the group aimed to develop resources and initiatives for Māori and Pacific communities to support future vaccination programmes. "While we believe moving away from injections will be a major benefit to improve vaccine uptake, using a kaupapa Māori framework, we want to find out what other barriers exist that prevent people from being vaccinated. "In particular we would like to reduce inequities that exist around vaccine uptake by Māori and Pacific people. "In Aotearoa New Zealand, it is imperative we increase vaccination rates, especially in groups with lower vaccine coverage. "Our research aims to minimise access and engagement immunisation barriers and enhance vaccination acceptance." Prof Hook was delighted to receive the funding and said the team was keen to start work on "this exciting research". The project is one of 18 Health Research Council grants awarded to University of Otago researchers, worth more than $15.3m. The council also awarded a $1.2m grant for Otago researchers to advance size-inclusive healthcare, by studying the acceptability and utility of cervical screening self-tests for "big-bodied" people. University of Otago (Wellington) primary healthcare and general practice researcher Associate Prof Lesley Gray said New Zealand's cervical screening programme now offered a universal self-testing option, which was expected to reduce inequities in participation and cancer outcomes. However, big-bodied people had historically been overlooked in research and under-served in screening, which increased their risk of undetected cervical cancer. She said cervical cancer was now preventable through vaccination, screening and timely treatment, and it was vital that the programme worked for people of all body sizes. "There are high levels of stigma and bias in healthcare associated with body size and fatness that mean people delay seeking help. "That impacts the quality of care people receive. "A range of factors determine how accessible services are from the built environment in which we deliver care, to the equipment and language we use in practice. "For example, the supplied swab is a standard length. We are interested to know how practical this is for big-bodied people wanting to self-test," she said. Assoc Prof Gray said the research aimed to understand how well the new screening pathway, including self-testing, met their needs. "Our pragmatic qualitative approach involves partnering with health and community providers to recruit big-bodied people to share their cervical screening experiences. "Findings will guide the development of practical approaches and recommendations for implementing size-inclusive cervical screening with broader relevance across all health services." Investing in the delivery of size-inclusive screening would help improve coverage and achieve downstream reductions in cancer incidence and mortality, she said. Meat processing is New Zealand's largest manufacturing sector, worth $12.2 billion to the economy and employing 28,000 people. But it is a hazardous work environment and has multiple health risks. University of Otago Va'a o Tautai Centre for Pacific Health postdoctoral fellow Dr Jane Taafaki has been given a Health Research Council grant of nearly $400,000 to investigate the workplace hazards that thousands of meatworkers face each day. "Pacific peoples are overrepresented in this industry and experience high rates of injury and work-related harm — a trend which is a growing concern in rural towns," she said. The first-of-its-kind study would take a Pacific approach to investigating the connection between the risk exposures in these kinds of manual labour industries and workers' health. Taking place in meat plants in Oamaru, Balclutha and Pareora, and using Pasifika fa'afaletui and talanoa methodologies, the study would examine the type and extent of workplace injury and illness, and how they relate to wider concepts of wellbeing, perception of workplace safety, risk exposures, and absenteeism. "We really want the outcomes of the project to be useful and informative to both the industry, as well as agencies like Te Whatu Ora Health New Zealand, WorkSafe and ACC, so that there are positive outcomes for the workers and industry alike." She said the research aimed to develop an instrument suitable for determining the nature and magnitude of musculoskeletal and associated health impacts for Pasifika people working in rural meat processing. It would also support the development of health services to respond to the health needs of rural Pacific meatworkers and their families more effectively. A drug used to treat anaemia (iron deficiency) also has the ability to cross into the brain. So University of Otago (Christchurch) medical laboratory science researcher Associate Prof Tania Slatter and pathology and biomedical science Professor Gabi Dachs are proposing the drug could also be used to treat some brain metastasis, by exploiting unique properties of these metastases. Two-thirds of cancer deaths occur when cancers spread around the body, and when cancer spreads to the brain (brain metastases), patients have "a dismal prognosis", because the metastases are challenging to treat. Assoc Prof Slatter said new treatment strategies were urgently needed in New Zealand. The duo received $1,196,992 from the Health Research Council to investigate if brain metastases were vulnerable to the anaemia drug, she said. "In the clinic and the laboratory, we will test if brain metastases have an iron accumulation signature that leads to greater drug uptake, and if this is sufficient to target metastases by triggering cancer cell death by iron overload." She said the anaemia drug was relatively low-cost with a good safety record, and might provide a new treatment opportunity and improved prognosis for those with otherwise limited treatment options. Colorectal cancer is one of the leading causes of death in New Zealand — especially in Otago and Southland where there are particularly high levels. While chemotherapy is a key treatment, it often causes unpleasant side effects which can reduce a person's ability to tolerate the treatment, and ultimately it makes it less effective. University of Otago School of Physical Education, Sport and Exercise Science researcher Dr Brendon Roxburgh has received a council Emerging Researcher Grant of $400,000 to evaluate the feasibility of exercise during chemotherapy. He believed exercise during chemotherapy might reduce side effects and improve treatment outcomes. "This research will begin by talking with people who have received or are receiving chemotherapy for colorectal cancer, to understand what helps or prevents them from being active during treatment. "We will use this information to develop a patient resource that supports safe physical activity during chemotherapy. "We will then test whether a supervised exercise programme during treatment is safe, manageable, and acceptable for people with colorectal cancer." Dr Roxburgh said the research could lead to better support for patients during treatment, improve their health outcomes, and provide a cost-effective way to improve cancer care across New Zealand. Other grants • Other research grants awarded to University of Otago researchers by the Health Research Council.— • Department of medicine researcher Dr Sarah Appleby has received a $150,000 Explorer Grant to create a new blood test to predict cardiovascular events. • Department of pathology researcher Dr Silke Neumann has received a $150,000 Explorer Grant to enhance chemotherapy sensitivity in patients with diffuse gastric cancer. • Department of oral sciences researcher Dr Zeina Al Naasan has received a $150,000 Explorer Grant to create an AI-assisted, easy-to-use smartphone-based app that can alleviate barriers to accessing oral healthcare advice, especially in communities with the highest needs. • Pathology and biomedical science researcher Prof Madhav Bhatia has received a $150,000 Explorer Grant to find pharmaceuticals that will enhance the body's lymphatic drainage system and help drain away pancreatic inflammation. • Department of surgery and critical care researcher Prof Tim Eglinton and department of pathology and biomedical science researcher Dr Arthur Morely-Bunker received a council grant of $699,734 to improve gastrointestinal cancer outcomes with AI-enhanced digital pathology. • Department of surgery and critical care researcher Dr Oliver Lyons and department of preventive and social medicine researcher Prof Sue Crengle received $1,439,803 to tackle gender inequity and provide better guidelines for doctors treating women with aneurisms. • Department of medicine researcher Dr Anna Pilbrow and department of pathology and biomedical science researcher Dr George Wiggins received $1,199,926 to study whether copy-number variation is a source of missing heritability for heart failure. • Department of biochemistry researcher Prof Parry Guilford and School of Pharmacy researcher Dr Jessica Fairhall received $1,199,177 from the council to investigate direct-to-stomach delivery of drugs for the chemoprevention of inherited stomach cancer. • Department of anatomy researchers Dr Michael Pankhurst and Prof Greg Anderson received $1,199,974 to study whether excessive ovarian hormones cause ovulation failure in polycystic ovary syndrome. • Department of physiology researcher Prof Peter Jones received $1,197,729 to study the treatment of Alzheimer's disease via inhibition of ryanodine receptors. • Department of biochemistry researcher Prof Sally McCormick received $1,170,000 to uncover the connection between serotonin and a form of blood cholesterol metabolism (Lp(a)). • Department of population health researchers Dr Rose Crossin and Prof Joseph Boden received $1,199,970 to define and measure drug (nicotine, alcohol, illicit drugs) harm for youth in New Zealand • Department of surgical sciences researcher Prof Greg Jones received $1,107,917 to improve how we predict someone's risk of cardiovascular disease, by testing a new blood test that more accurately measures a person's lifetime exposure to smoking.
Otago Daily Times
11 hours ago
- Otago Daily Times
SRH system failing wāhine Māori: study
Chelsea Harris. Photo: supplied New Zealand's sexual and reproductive healthcare (SRH) system is leaving many Māori women feeling "dehumanised and disempowered". A new University of Otago (Christchurch) study has highlighted potential areas of improvement in the quality of sexual and reproductive healthcare services delivered to wāhine in New Zealand. Lead author, primary care doctor and department of primary care and clinical simulation teaching fellow Dr Chelsea Harris said 12 Māori women, aged 25-57, were interviewed about their experiences interacting with the healthcare system for SRH issues. The research found most received insufficient information when making decisions about issues such as contraceptive options and diagnostic procedures, and they had concerns about not being kept "in the loop" when experiencing stressful events such as abnormal cervical smear results, or childbirth not progressing according to plan. It left many feeling dehumanised, disempowered, scared and dismissed, which affected their psychological wellbeing and trust in the medical system, Dr Harris said. "Being uninformed perpetuates health inequities, both indirectly by eroding the trust wāhine have in healthcare services, and directly by limiting the effectiveness of healthcare encounters. "Our data showed that wāhine benefit from services and care that make them feel comfortable and respected, but that dehumanising care can impact their future engagement with services. "How and when information is provided is so important." She said receiving information immediately before a procedure could be distressing, and it was already known women who underwent gynaecological or obstetric procedures without adequate consent were at risk of developing post-traumatic stress disorder. Dr Harris said the research highlighted it could be difficult to identify and access reliable SRH information. "Health literacy is often seen as the responsibility of the individual. "However, previous researchers have argued it's the responsibility of health professionals to support the health literacy of our patient." She believed the wider dissemination of reliable SRH information to wāhine Māori could improve outcomes, particularly if it was Māori-led by design. The research also found healthcare professionals and environments played a vital role in helping wāhine Māori feel empowered or, conversely, disempowered during SRH encounters. It found clinics and hospital environments could be intimidating and counterproductive to maintaining confidentiality. "The spaces we create in healthcare — not just their physical qualities, but also their warmth, non-judgementalism and safety — play an important role in setting the tone for healthcare encounters. "This begins in the waiting room. "Do patients absolutely need to speak to the receptionist in front of a waiting room full of other people? Are they greeted by a friendly face?" She said many women reported a preference for female staff when accessing SRH healthcare, but showing kindness and respect helped wāhine feel more comfortable seeing male healthcare staff, Dr Harris said. "Also, regardless of gender, the participants reported that a sense of humour was an added bonus." The research concluded SRH care should support the mana (status or prestige) of the patient.
Otago Daily Times
2 days ago
- Otago Daily Times
Robertson troubled by 'health issues' in build-up to election
Grant Robertson fought the 2023 election hobbled by chronic back pain and in the wake of a related major health scare, his newly published autobiography reveals. The former deputy prime minister and finance minister — who is now vice-chancellor of the University of Otago — injured his back playing rugby while growing up in Dunedin. In his book, Anything Could Happen , Mr Robertson writes that he re-aggravated the old injury just before the 2022 Labour party conference, and that scans revealed he had a ruptured disc. On the last working day of that year he had scheduled a spinal cortisone injection to give him some pain relief. ''In a one in 10,000 event the anaesthetic that is used as part of the CT-guided injection was put in the wrong place,'' he wrote. ''As I went to stand up after the procedure my legs felt incredibly heavy. I tried to get up and could not. I had lost all the feeling below my waist ... after an awful night the feeling slowly came back and I was discharged.'' The health scare coincided with then Prime Minister Jacinda Ardern having confidentially told Mr Robertson that she was contemplating resigning and retiring from politics — as she did early the following year. A ''highly strung'' Mr Robertson was in Dunedin that Christmas and, fearful he would re-aggravate his uninjured back, he started to have anxiety issues. Having been given medication, he made the unwise decision not to take it. ''About 2am I woke up and began shaking uncontrollably. I could not stop ... after what felt like hours, my heart began to slow a bit and the shaking stopped. I had no idea what a panic attack was, but it is clear to me now that this is what it was.'' After returning to Wellington Mr Robertson called then Health Minister Dr Ayesha Verrall and asked for the name of someone to talk to. ''Contacting them was the best decision I had made in many years in politics. I had conversations with a couple of people and settled on a therapist who would help me through my remaining time in Parliament.'' Mr Robertson writes that his bad back pain persisted through the election campaign and limited how much he — one of Labour's best campaigners — could contribute. ''I flew to Auckland and then down to Queenstown, popping pills all the way, to keep me going. I tried my best but in the final couple of weeks of the campaign the pain of sitting on flights was just too much and I had to pull out of a few events. ''I felt terrible letting colleagues down, but my body was calling time even if my mind was still going.'' Mr Robertson also reveals his misgivings about the party's 2023 tax policy. Having had his preferred option, a capital gains tax rejected, he was obliged to campaign on a policy of removing GST from fruit and vegetables — something he had previously called a ''boondoggle''. ''To be frank, I don't think I was very convincing,'' he said of his announcement speech. In an interview with the Otago Daily Times , Mr Robertson said he had given momentary thought to putting his name forward to replace now Dame Jacinda when she stepped down — although he had previously, and adamantly, said he would never stand for the Labour party leadership again after two previous failed bids for the top job. ''Of course I thought about it,'' he said. ''But I thought about it more in that context of not wanting to let others down, but I couldn't get past the fact that I'd made that decision and I was very comfortable with the role I was playing, and also I just knew what it would take, and not just because of the physical health issues I was facing, but also just where I was in my political career, and it just wasn't there.'' Mr Robertson said that Chris Hipkins had done his best to try to secure a third term for Labour. ''I don't think it mattered who the leader was, we were going to lose that election,'' he said. ''There were things that could have done better, and there is, I guess with Jacinda there's no counterfactual, what she might have been able to pull off, but that was an election where cost of living was just doing us in as a government. ''I continue to believe that we, you know, it might have been a different result in terms of the percentages, but I'm not sure once Jacinda left anyway that there was another result.'' ■ Anything Could Happen is published tomorrow. A full feature interview with Grant Robertson will run in The Weekend Mix on Saturday.
