Levels and determinants of knowledge about chronic migraine diagnosis and management among primary health-care physicians in ministry of health, Jeddah 2019

BACKGROUND: Chronic migraine (CM) poses a significant burden for patients, and it has multiple diagnostic and managemental challenges, particularly among primary health-care physicians (PCPs). OBJECTIVES: The objective of this study is to assess the levels of knowledge regarding CM diagnosis and management among PCPs and to explore the factors associated with poor knowledge. METHODS: A cross-sectional study was conducted among PCPs working at primary health-care centers in Jeddah, Saudi Arabia. A semi-structured questionnaire comprising 20 items related to CM diagnosis and treatment was used. RESULTS: A total of 136 PCPs responded (aged 36.4 ± 8.1, 68.4% were females). The overall median (P75) knowledge score was 13.0 (15.0), and 45.6% of the participants had adequate knowledge (score > median). The majority of respondents (>50%) could not identify the lower limits of CM duration, the necessity of identifying at least eight migraine attacks in a month, the importance of managing medication overuse, and the indication of topiramate as the most efficacious agent in CM. Young physicians (23–35 years), bachelor graduates, general practitioners (GPs), and those having ≤5 years of experience scored lower than their peers. Physicians with 6–10 years of clinical experience were independently more knowledgeable than less-experienced PCPs (odds ratio = 5.09, P = 0.006). CONCLUSION: Knowledge regarding CM diagnosis and treatment was inadequate among PCPs, which could detrimentally influence the patterns of referral to secondary health-care facilities. Given these observations, it is recommended to amend the academic curricula for medical students/GPs and adopt continuing medical education programs for PHPs to support their levels of knowledge.