About

Michael Reed is currently on leave from the University of Virginia, serving as Associate Vice President of Westlake University in Hangzhou, China. His research interests center around micro- and nanofabrication technologies, and microsystems applications. He has held appointments at Hewlett-Packard Laboratories, Carnegie-Mellon University, University of Twente, ETH Zürich, and the Albert Ludwigs Universität, Freiburg. Professor Reed’s contributions include serving as the Technical Chairman of the 1995 IEEE International Workshop on MEMS and as the General Chairman of the 1996 Workshop. He was a founder of Setagon, Inc., a biomedical device startup developing microfabricated drug and gene delivery systems, which was acquired by Medtronic in 2007. He holds 17 issued patents related to microsystems technology and microfabricated medical devices. Additionally, he is the author of the textbook Applied Introductory Circuit Analysis for Electrical and Computer Engineers and has approximately 130 research publications. Professor Reed has received the Hertz Foundation Prize, a Presidential Young Investigator Award, and is recognized as a National Distinguished Expert of the Chinese Thousand Talent Plan. He is also a Fellow of the Institute of Physics.

Research topics

• Internal medicine
• Medicine
• Psychiatry
• Physical therapy
• Environmental health
• Demography
• Family medicine

Selected publications

• Unmet treatment needs in migraine: Results of the OVERCOME (US) study

  Headache The Journal of Head and Face Pain · 2026-02-20

  articleOpen access

  OBJECTIVE: To examine acute and preventive migraine prescription treatment needs among participants with active migraine and identify factors associated with needing treatment optimization. BACKGROUND: A high unmet treatment need exists for individuals with migraine. METHODS: ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (United States) is a prospective, multi-cohort, longitudinal, web-based survey in a demographically representative sample of US adults with active migraine in the preceding year. The current study is a pooled analysis of the baseline surveys of the 2018, 2019, and 2020 migraine cohorts. Criteria for determining need for migraine treatment initiation/modification were based on the American Headache Society 2021 consensus statement. For preventive treatment, need was defined based on the number of headache days per month and Migraine Disability Assessment Scale scores. For acute treatment, need was defined using the Migraine Treatment Optimization Questionnaire scores or based on the presence of two or more disability days per month. Participants were categorized into four groups based on their need for initiation/modification of acute or preventive treatment or both. The categories were "not a candidate (no need for treatment initiation/modification)," "acute need only," "preventive need only," or "preventive + acute needs." Interictal burden was measured using the Migraine Interictal Burden Scale-4. RESULTS: Among 59,001 participants with migraine, 77.1% of the total population were candidates for migraine prescription treatment initiation/modification. Among those, 39.4% had unmet acute needs only, 2.8% had unmet preventive needs only, and 34.9% met criteria for both. Up to one-quarter of participants in each group were taking preventive medication. Acute prescription medication use was reported by 55.7% of those with preventive + acute needs, 46.9% of those with acute needs only, 36.9% of those with preventive needs only, and 27.1% of those who were not candidates for treatment initiation/modification. The highest rate of acute medication overuse was seen in the preventive + acute needs group (37.0%). Over half of the participants in the preventive + acute (69.9%) and acute (58.7%) needs groups reported experiencing moderate-to-severe interictal burden on the Migraine Interictal Burden Scale-4. Migraine-related stigma was highest among those with acute + preventive treatment needs, with 46.4% experiencing stigma often or very often. Experiencing severe interictal burden was most associated with having acute treatment needs (odds ratio [OR], 2.66; 95% confidence interval [CI], 2.48-2.86), whereas overusing acute medication was most associated with having preventive treatment needs (OR, 10.04; 95% CI, 8.64-11.65) and preventive + acute treatment needs (OR, 10.19; 95% CI, 9.09-11.43). CONCLUSION: Over 75% of participants with migraine in this population sample were candidates for initiation or modification of migraine prescription treatment. These findings highlight the opportunity for optimizing treatment and improving outcomes for patients with migraine.

  PublisherOA PDFDOI

• Opioid Use among People with Migraine: Results of the OVERCOME (US) Study

  Pain and Therapy · 2025-09-19

  articleOpen access

  INTRODUCTION: Despite expert recommendations against using opioids for migraine treatment, their use remains common in the USA. We aimed to evaluate the use of opioids among people with active migraine using data from the Observational Survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME) (US) study. METHODS: This observational, longitudinal, web-based survey study included a demographically representative sample of adults with migraine in the USA (2018-2020). Participants with migraine (International Classification of Headache Disorders, third edition [ICHD-3]) and ≥ 1 headache in the previous 12 months were identified via a questionnaire and/or self-reported diagnosis. Information on opioid use for acute migraine treatment was collected. Demographics, clinical, and migraine-related characteristics among those with current opioid use and those with non-use were evaluated in the cross-sectional analysis using standardized mean difference (SMD). Multivariable analysis was conducted using machine learning (least absolute shrinkage and selection operator regression, random forest) and logistic regression models to assess factors associated with current opioid use. RESULTS: Of 61,932 respondents with active migraine, 13,331 (21.5%) reported currently using opioids to treat migraine. Among those using opioids, 68.0% were female, 64.3% identified as White, and 13.7% identified as Hispanic. Those currently using opioids differed from those not using opioids in various characteristics, including higher tobacco/marijuana use, more comorbidities, higher migraine-related disability, and higher interictal burden (all SMD > 0.2). The factors most associated with current opioid use were "currently taking recommended acute medications for migraine" (odds ratio [OR], 10.1; confidence interval [CI], 9.47, 10.78), "currently taking barbiturates for migraine" (OR, 2.2; CI, 2.03, 2.34), and "sought care at an Emergency Department/Urgent Care for migraine in the previous 12 months" (OR, 1.7; CI, 1.67, 1.85). CONCLUSIONS: This study shows that opioid use for migraine is associated with using recommended acute medications, barbiturates, and emergency department care for migraine. Understanding how to limit these factors is key to developing interventions to reduce opioid use in migraine.

  PublisherDOI

• What a long strange trip it's been: Reflections on serial snapshots of migraine prevalence and burden in the United States

  Headache The Journal of Head and Face Pain · 2025-06-05

  editorial

  Fred Cohen serves as an assistant editor for Headache. He has received honoraria from Springer Nature and Medlink Neurology. Caroline Brooks declares no conflicts of interest. Daniel Sun declares no conflicts of interest. Dawn Buse has been a consultant and/or received research funding from Abbvie/Allergan, Amgen, Biohaven, Collegium, GSK, Lilly, Lundbeck, and Teva. Work supported by Abbvie/Allergan, Lilly, and OrthoMcNeil is reviewed in this manuscript. Michael Reed is the managing director of Vedanta Research, which has received research funding from AbbVie, Allay Lamp, Dr. Reddy's Laboratories, Eli Lilly, and GlaxoSmithKline via grants to the National Headache Foundation. Christina Fanning is managing director of MIST Research, which has received research funding from AbbVie, NYU Langone Heal, Allay Lamp, Juva Health, and GlaxoSmithKline via grants to the National Headache Foundation. Richard Lipton receives research support from the NIH and FDA, as well as the National Headache Foundation and the Marx Foundation. He also receives research support from Allergan/AbbVie, Amgen, Eli Lilly, and Electrocore. He receives personal fees as a consultant or advisor from Allergan/AbbVie, Amgen, Biohaven Holdings, Cooltech, GlaxoSmithKline, Grifols, Heleon, Impel, Eli Lilly, Lundbeck, Merck, Pfizer, and Teva Pharmaceuticals. He holds stock or options in Axon, Biohaven Holdings, CoolTech, and Manistee. In addition, he receives royalties for Wolff's Headache 7th and 8th Edition.

  PublisherDOI

• Development of the Migraine‐Related Stigma (MiRS) Questionnaire: Results of the OVERCOME (US) Study

  Headache The Journal of Head and Face Pain · 2025-01-22 · 4 citations

  articleOpen access

  BACKGROUND: Stigma is emerging as an important social contributor to migraine-related disability and other outcomes. Currently, there are no published validated measures of migraine-specific measures of stigma. OBJECTIVES: This secondary post hoc analysis of a cross-sectional cohort study aimed to develop a questionnaire to evaluate migraine-related stigma. METHODS: Based on focus group discussions among persons with migraine and literature review, a panel of migraine experts iteratively developed 12 candidate items for the migraine-related stigma (MiRS) questionnaire, which aims to measure if and how people living with migraine perceive they are viewed in a stigmatizing manner by others. The United States ObserVational survey of the Epidemiology tReatment and Care Of MigrainE (OVERCOME) study identified people with active migraine within a demographically representative United States (US) adult sample and administered the novel MiRS questionnaire in addition to questionnaires assessing sociodemographics, monthly headache days, and migraine disability score (Migraine Disability Assessment) among other data. Exploratory factor analysis was then utilized to evaluate the structure of the MiRS items and determine the Cronbach's alpha described internal consistency of the factors. RESULTS: This exploratory factor analysis was a secondary post hoc analysis of a cross-sectional cohort study derived from the OVERCOME population-based web survey, which was conducted in a United States sample of 61,932 adults with migraine. The mean (standard deviation) age was 41.7 (14.8) years, 74.5% (n = 46,122) were female, and 70.3% (n = 43,564) identified as White. Two factors were identified: MiRS-external perception of Secondary Gain (eigenvalue = 21.5, percentage of total variance = 88.9%) and MiRS-external perception of Minimizing Burden of migraine (eigenvalue = 2.7, percentage of total variance = 11.1%). The two factors were correlated (r = 0.66) and a non-orthogonal varimax rotation showed that eight items loaded onto the MiRS-Secondary Gain factor, and four items loaded onto the MiRS-Minimizing Burden factor. CONCLUSION: This population-based study of >60,000 people with migraine allowed the development and validation of the first migraine-specific measure of perceived external stigma for people with migraine. This study demonstrated that MiRS consists of two internally consistent subscales: Secondary Gain and Minimizing Burden. This may be a useful tool for quantifying perceived migraine-related stigma to understand determinants of migraine-related stigma and test interventions to reduce perceived migraine-related stigma.

  PublisherOA PDFDOI

• Challenges and opportunities for estimating and assessing migraine prevalence, incidence and impact across study populations and methodologies: Bridging global and <scp>United States</scp> findings

  Headache The Journal of Head and Face Pain · 2024-10-23

  letterOpen access

  We would like to thank Tavasoli et al.1 for their insightful and detailed letter and the Headache editorial board for the opportunity to respond. In our recent summary of United States population-based epidemiologic studies on migraine prevalence and burden, we reported that migraine prevalence has remained relatively stable among eligible studies conducted over the last three decades. However, the proportions of individuals with migraine who have chronic migraine and migraine-related disability, as measured by the Migraine Disability Assessment Scale, have increased.2 Eligible studies evaluated representative samples of the United States population and ascertained migraine status using validated diagnostic questionnaires based on International Classification of Headache Disorders criteria, either by telephone interview, mailed questionnaire, or web survey. The methodological similarities among these studies and the use of virtually identical diagnostic questionnaires and diagnostic criteria simplified comparisons among studies. As the investigators assigned migraine diagnoses based on standard criteria, prevalence is independent of rates of consultation and diagnosis. Not reported in our paper was the observation that rates of consultation and diagnosis of migraine have risen in the United States over the last several decades.3 Because of these difficulties, incidence studies are often conducted using medical claims databases or electronic medical record data sets to define a group free of migraine that is followed for migraine onset. These studies do not exclude migraine from the “to be followed” sample; they exclude medically diagnosed migraine, which is only a subset of people with migraine. These studies do not measure the onset of migraine in those previously free of it; they measure the rate of onset of medically diagnosed migraine in those free of a previous diagnosis. Instead of using medical claims or pharmacy data, some studies ask participants to report if a healthcare professional ever diagnosed them or told them that they had migraine or a related diagnosis (e.g., chronic migraine). Therefore, an improvement in rates of consultation and diagnosis, or even improvements in migraine awareness (leading to better recollection of diagnosis) may artificially inflate estimates of disease incidence and prevalence. Measured rates of migraine consultation and diagnosis have risen for migraine over the past 30 years in the United States and around the world. This represents progress in diagnosis and treatment, which we attribute to decades of advocacy and educational efforts.3, 5-9 It is possible that some of the studies summarized by Fan et al.10 overestimate increased incidence because of increases in consultation, diagnosis, and disease awareness. Resolving this issue requires careful dissection of the methods of all the studies included in the review. As Tavasoli et al.1 point out, the greatest increases in “incidence” are seen in a group of early adolescents. It is possible that increased consultation and diagnosis in that group may contribute to this age effect. Migraine prevalence and incidence demonstrably vary with age, sex, race, ethnicity, and socioeconomic status, among other factors.11 Dissociations between prevalence and incidence are of great interest. Prevalence is a function of both incidence and duration.12 If prevalence were stable as incidence increased that could mean that duration of illness was decreasing and perhaps may be a positive sign for the effects of treatment and care. We would like to believe that better treatment and reduction in exacerbating factors such as medication overuse, among other factors, could keep prevalence stable in the setting of rising incidence. Unfortunately, we are not sure that incidence is rising, at least in the United States. Further epidemiologic studies are needed to assess these issues. These studies must be designed to accurately ascertain migraine status, systematically eliminating the influence of changes in consultation and diagnosis. As Tavasoli et al.1 rightly pointed out, the studies included in our review predate the global COVID-19 pandemic. Social norms and life in general have changed in many ways since then which could affect migraine incidence, prevalence, attack frequency, and impact (e.g., an increase in screen time, changes in work and school schedules including virtual options, reduction in social interactions).13, 14 Additionally, as noted in our discussion, the studies we reviewed largely predate the use of calcitonin gene-related peptide-targeted therapies. Future carefully designed epidemiological research will be necessary to further explore changes in the experience and burden of migraine, especially in adolescents. Fred Cohen: Conceptualization; formal analysis; investigation; methodology; project administration; supervision; validation; visualization; writing – original draft; writing – review and editing. Caroline V. Brooks: Conceptualization; formal analysis; methodology; validation; writing – original draft; writing – review and editing. Daniel Sun: Conceptualization; formal analysis; investigation; methodology; validation; writing – review and editing. Dawn C. Buse: Conceptualization; formal analysis; investigation; methodology; validation; writing – original draft; writing – review and editing. Michael L. Reed: Formal analysis; investigation; methodology; validation; writing – review and editing. Kristina M. Fanning: Conceptualization; formal analysis; investigation; methodology; validation; writing – review and editing. Richard B. Lipton: Conceptualization; formal analysis; investigation; methodology; supervision; validation; writing – original draft; writing – review and editing. Fred Cohen is an associate editor for Headache. He has also been a consultant/speaker for Abbvie, Eli Lilly, and Pfizer and received honoraria from Springer Nature and Medlink Neurology. Caroline V. Brooks has no disclosures to report. Daniel Sun has no disclosures to report. Dawn C. Buse has been a consultant and/or received research funding from Abbvie/Allergan, Amgen, Biohaven, Collegium, GSK, Lilly, Lundbeck, and Teva. Work supported by Abbvie/Allergan, Lilly, and OrthoMcNeil is reviewed in this manuscript. Michael Reed is the Managing Director of Vedanta Research, receiving research funding from AbbVie, Allay Lamp, Dr. Reddy's Laboratories, Eli Lilly, and GlaxoSmithKline via grants to the National Headache Foundation. Kristina M. Fanning is the Managing Director of MIST Research, which has received research funding from AbbVie, NYU Langone Heal, Allay Lamp, Juva Health, and GlaxoSmithKline via grants to the National Headache Foundation. Richard B. Lipton receives research support from the National Institutes of Health, United States Food and Drug Administration, as well as the National Headache Foundation and the Marx Foundation. He also receives research support from Allergan/AbbVie, Amgen, Eli Lilly, and Electrocore. He receives personal fees as a consultant or advisor from Allergan/AbbVie, Amgen, Biohaven Holdings, Cooltech, GlaxoSmithKline, Grifols, Heleon, Impel, Eli Lilly, Lundbeck, Merck, and Teva Pharmaceuticals. He holds stock or options in Biohaven Holdings and Manistee. In addition, he receives royalties for Wolff's Headache and Other Head Pain, Seventh and Eighth Editions.

  PublisherOA PDFDOI

• Prevalence and burden of migraine in the United States: A systematic review

  Headache The Journal of Head and Face Pain · 2024-05-01 · 63 citations

  reviewOpen access

  BACKGROUND: This study reviewed migraine prevalence and disability gathered through epidemiologic survey studies in the United States conducted over the past three decades. We summarized these studies and evaluated changing patterns of disease prevalence and disability. METHODS: We conducted a systematic review of US studies addressing the prevalence, disability, and/or burden of migraine, including both episodic migraine (EM) and chronic migraine (CM). A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used in conjunction with the PubMed search engine. Eligible studies were published before February 2022, were conducted in the United States, included representative samples, and used a case definition of migraine based on the International Classification of Headache Disorders (ICHD). The primary measure of disease burden was the Migraine Disability Assessment Scale (MIDAS). The MIDAS measures days lost due to migraine over 3 months in three domains and defines groups with moderate (Grade III) or severe disability (Grade IV) using cut-scores. RESULTS: Of the 1609 identified records, 26 publications from 11 US population-based studies met eligibility criteria. The prevalence of migraine in the population has remained relatively consistent for the past 30 years: ranging from 11.7% to 14.7% overall, 17.1% to 19.2% in women, and 5.6% to 7.2% in men in the studies reviewed. CM prevalence is 0.91% (1.3% among women and 0.5% of men) in adults and 0.8% in adolescents. The proportion of people with migraine and moderate-to-severe MIDAS disability (Grades III-IV), has trended upward across studies from 22.0% in 2005 to 39.0% in 2012, to 43.2% in 2016, and 42.4% in 2018. A consistently higher proportion of women were assigned MIDAS Grades III/IV relative to men. CONCLUSION: The prevalence of migraine in the United States has remained stable over the past three decades while migraine-related disability has increased. The disability trend could reflect changes in reporting, study methodology, social and societal changes, or changes in exacerbating or remediating factors that make migraine more disabling, among other hypotheses. These issues merit further investigation.

  PublisherOA PDFDOI

• Advancing Bioremediation: Genetic Approaches to Environmental Cleanup

  American Journal of Biological Sciences · 2024-10-31

  articleOpen access1st authorCorresponding

  Bioremediation, the use of living organisms to clean up environmental pollutants, is a promising strategy for addressing contamination in soil, water, and air. This article explores genetic approaches to advancing bioremediation, focusing on the development of genetically engineered microorganisms and plants to enhance their ability to degrade or transform hazardous substances. We discuss the mechanisms of pollutant degradation, the genetic modifications that improve bioremediation efficiency, and the challenges and future directions of this field. Furthermore, we highlight recent advancements in synthetic biology and its role in creating novel bioremediation solutions for complex environmental pollutants.

  PublisherOA PDFDOI

• Plain Language Summary Publication: Characterizing neck pain during headache among people with migraine: Multicountry results from the Chronic Migraine Epidemiology and Outcomes – International ( <scp>CaMEO‐I)</scp> cross‐sectional study

  Headache The Journal of Head and Face Pain · 2024-07-16

  article

  Main Findings: In a large, multinational web survey, neck pain with headache (NPWH) occurred in more than two-thirds of people with migraine compared with about one-third of people with non-migraine headache. Among people with migraine, those with NPWH had greater disability, depression symptoms, anxiety symptoms, and allodynia, diminished quality of life, and reduced work productivity. Motivation (Problem): We sought to determine how frequently people with migraine and people with non-migraine headache had NPWH and to examine the association of neck pain with migraine disease burden. We also considered the possibility that NPWH could be used as a diagnostic feature or a measure of disease burden and treatment benefit in clinical trials. Methods: We conducted a web-based study in a representative sample of the general population of six countries: Canada, France, Germany, Japan, the United Kingdom, and the United States. About one-quarter of those with headache had migraine; three-quarters had other headache types. Results: In people with migraine, those with NPWH were 1.7 times more likely to have moderate-to-severe headache-related disability and had 1.7 times more lost productive time at work. Those with NPWH were also more likely to have depression and anxiety symptoms and were less likely to respond well to their usual acute treatments in every country but Japan. When asked to identify the symptoms that bothered them the most, 28.4% of respondents with migraine and NPWH reported neck pain as their most bothersome symptom. While NPWH was associated with substantial burden in all countries, Japan had the lowest rate of moderate-to-severe disability among respondents with NPWH (35.6% compared with 42.7%–55.3% in other countries). Implications (for the future): NPWH is more common in migraine than in other headache types and is associated with higher levels of disability and more lost productive time at work. More than a quarter of people with migraine and NPWH find neck pain to be their most bothersome symptom. Including neck pain as a diagnostic feature of migraine could improve migraine diagnosis, and measuring neck pain in clinical trials could make these studies more patient centered. We hypothesize that the strikingly lower impact of NPWH observed in Japan may be related to cultural differences in attitudes toward pain that influence symptom reporting, although additional data are needed. Study concept and design: Dawn Buse, Richard B. Lipton, and Katherine Sommer. Acquisition of data: Kristina M. Fanning, Michael L. Reed, and Katherine Sommer. Analysis and interpretation of data: Kristina M. Fanning, Richard B. Lipton, Michael L. Reed, and Katherine Sommer. Drafting of the manuscript: Manjit Matharu, Zaza Katsarava, Dawn C. Buse, Katherine Sommer, Michael L. Reed, Kristina M. Fanning, and Richard B. Lipton. Revising it for intellectual content: Manjit Matharu, Zaza Katsarava, Dawn C. Buse, Katherine Sommer, Michael L. Reed, Kristina M. Fanning, and Richard B. Lipton. Final approval of the completed manuscript: Manjit Matharu, Zaza Katsarava, Dawn C. Buse, Katherine Sommer, Michael L. Reed, Kristina M. Fanning, and Richard B. Lipton. Manjit Matharu, MD, serves on the advisory board for Abbott, AbbVie, Eli Lilly, Lundbeck, Medtronic, Pfizer, Salvia, and Teva and has received payment for the development of educational presentations from AbbVie, electroCore, Eli Lilly, Novartis, and Teva. Zaza Katsarava, MD, has been a speaker and/or consultant and/or received research support from Allergan, Amgen/Novartis, Eli Lilly, Merck, and Teva. Dawn C. Buse, PhD, has received grant support and honoraria from AbbVie, Amgen, Biohaven, Collegium, Eli Lilly, Lundbeck, Teva, and Theranica and serves on the editorial board of Current Pain and Headache Reports. Katherine Sommer, PhD, was an employee of AbbVie at the time this study was conducted and may hold AbbVie stock. Michael L. Reed, PhD, is managing director of Vedanta Research, which has received research funding from AbbVie, Allay Lamp, Dr. Reddy's Laboratories, Eli Lilly, and GlaxoSmithKline via grants to the National Headache Foundation. Vedanta Research has received funding directly from AbbVie for work on the CaMEO and CaMEO-I Studies. Kristina M. Fanning, PhD, is managing director of MIST Research, which has received research funding from AbbVie, Allay Lamp, NYC Langone Health, Juva Health, and GlaxoSmithKline via grants to the National Headache Foundation. Richard B. Lipton, MD, reports support for the present study from AbbVie; research support paid to his institution from the Czap Foundation, National Headache Foundation, National Institutes of Health, S&L Marx Foundation, and US Food and Drug Administration; and personal fees from AbbVie/Allergan, American Academy of Neurology, American Headache Society, Amgen, Biohaven, Biovision, Boston, Dr. Reddy's (Promius), electroCore, Eli Lilly, GlaxoSmithKline, Grifols, Lundbeck (Alder), Merck, Pernix, Pfizer, Teva, Vector, and Vedanta Research. He holds stock/options in Axon, Biohaven, CoolTech, and Manistee.

  PublisherDOI

• Factors and Reasons Associated with Hesitating to Seek Care for Migraine: Results of the OVERCOME (US) Study

  Neurology and Therapy · 2024-11-02 · 5 citations

  articleOpen access

  INTRODUCTION: Despite a variety of available treatment options for migraine, many people with migraine do not seek medical care, thereby reducing opportunities for diagnosis and effective treatment and potentially leading to missed opportunities to reduce the burden of disease. Understanding why people hesitate to seek care for migraine may help healthcare professionals and advocates address barriers and improve outcomes. The aim of this study, in a large adult population sample in the United States (US), was to identify factors associated with and reasons for hesitating to seek healthcare for migraine. METHODS: The web-based OVERCOME (US) survey study identified adults with active migraine in a demographically representative US sample who answered questions about hesitating to seek care from a healthcare provider for migraine and reasons for hesitating. Supervised machine learning (random forest, least absolute shrinkage and selection operator) identified factors associated with hesitation; logistic regression models assessed association of factors on hesitation. RESULTS: The study results show that of the 58,403 participants with active migraine who completed the OVERCOME (US) baseline survey and provided responses to the question on hesitating to seek care for migraine, 45.1% (n = 26,330/58,403) with migraine indicated that they had ever hesitated to seek care for migraine. Factors most associated with hesitating to seek care were hiding migraine (odds ratio [OR] = 2.69; 95% confidence interval [CI]: 2.50, 2.89), experiencing migraine-related stigma (OR = 2.13; 95% CI 1.95, 2.33), higher migraine-related disability (OR = 1.30; 95% CI 1.23, 1.38), and higher ictal cutaneous allodynia (OR = 1.26; 95% CI 1.19, 1.35). The most common reasons participants stated for hesitating included (1) 44.2% wanting to try and take care of migraine on their own, (2) 33.8% feeling that their migraine or headache would not be taken seriously, (3) 29.2% thinking that their migraine was not serious/painful enough, and (4) 27.4% not being able to afford it or not wanting to spend the money. The main limitation of the study includes the requirement for respondents to have internet, access which may have reflected cohort bias, and the quota sampling rather than random sampling to create a demographically representative sample. CONCLUSIONS: Hesitating to seek migraine care is common and is most strongly associated with hiding the disease and migraine-related stigma. Those experiencing higher migraine-related burden are more hesitant to seek the care that might alleviate the burden. These findings suggest that migraine's social context (e.g., stigma) is a major determinant of hesitance to seek migraine care.

  PublisherOA PDFDOI

• E044 The role of patient education in a joint injection clinic. The most ‘cost effective’ approach for the management of your arthritis

  Lara D. Veeken · 2024-04-01

  article

  Abstract Background/Aims GGH operates a self-referral joint injection clinic where patients suffering from an acute arthritis flare, can call and book an appointment for review and possible joint injection. The self referral service applies to all the patients attending the GGH rheumatology service and are under the care of a rheumatologist. A screening questionnaire was originally designed to triage those requesting appointments last year. We have amplified this work further this year by raising awareness and educating patients about their rheumatological condition and specifically about steroid intra-articular joint injections. Their benefits, risks and their indications. Aims-1. Providing education and awareness of joint injections in the community aiding patients to participate in their joint care. 2. Help patient understand the indications, side effects and risks involved with repeated injection . 3. To know the difference between osteoarthritis and inflammatory arthritis. Methods Retrospective study of patients who self-referred for joint injection between 07/07/2022 and 22/05/2023. Total of 138 self referred via phone calls, emails or letters. All the self referral data was compiled, assessed by screening questions and reviewed. An education and awareness campaign was made possible through an improved waiting room, educational pamphlets, leaflets and 1:1 consultations. Results Two pools of patients who received joint injections were analysed. Group A (07/07/2022 - 08/12/2022) where 102 patients self-referred and 43 received a joint injection. Group B (04/01/2023 - 22/05/2023) 36 self-referred and 15 received injection. The table below shows the different demographics of the two groups. Conclusion Patient Education remains one of the most important cornerstones in management of arthritis patients. After an ongoing campaign of education/awareness, self referrals were reduced by 66 %.This audit demonstrates that patient education about joint injections allows for more effective management, allowing better informed shared care. It also reduces the waiting times for patients to be seen in the injection clinic - from 3 months to 2 weeks. A cost effective approach in service improvement. Population who still availed joined injection in the re- audit were more elderly, obese, female, and had more metabolic diseases however the self referral to injection ratio is almost the same both groups. Disclosure S. Maunick: None. C. Mullet: None. T. Mccoll: None. M. Reed: None. M. Gupta: None. M. Hafeez: None. S. Bawa: None.

  PublisherDOI

Recent grants

• NIRT: Science and Technology of Nanoporous Metal Films

  NSF · $1.4M · 2005–2010

Frequent coauthors

• Richard B. Lipton

  Albert Einstein College of Medicine

  408 shared

• Dawn C. Buse

  Albert Einstein College of Medicine

  267 shared

• Kristina M. Fanning

  IST Research

  209 shared

• Daniel Serrano

  148 shared

• Aubrey Manack Adams

  AbbVie (United States)

  115 shared

• Todd J. Schwedt

  Mayo Clinic

  76 shared

• Dawn C. Buse

  Albert Einstein College of Medicine

  59 shared

• Giovanni Zangari

  45 shared

Awards & honors

• Hertz Foundation Prize
• Presidential Young Investigator Award
• National Distinguished Expert of the Chinese Thousand Talent…
• Fellow of the Institute of Physics