Australia gets first multidisciplinary institute for migraine


By Natasha Doyle

17 May 2022

Australian clinicians are bringing neurologists and other healthcare professionals under one roof, in the hopes of improving patient outcomes and driving an end to migraine disability.

The Australian Institute of Migraine (AIM) launched in Melbourne on Monday (16 May), marking the country’s first dedicated migraine centre with multidisciplinary input and patient and carer co-design, Professor Tissa Wijeratne, neurologist, AIM co-founder and migraine advocate told the limbic.

The collaborative space already has 15 neurologists on board and is set to house physiotherapists, psychologists, psychiatrists, social workers, nurses, exercise physicians, occupational therapists and dieticians, offering patients easier access to diagnostic, therapeutic and rehabilitative care.

It’s also partnering with universities and hospitals to advance research and education, according to the AIM website.

Professor Wijeratne said the site was a “small seed” in what he hopes will one day be a virtual and physical “rainforest” spanning Australia, China, India, Indonesia, Sri Lanka and beyond.

“Close to two-thirds of the world population lives in our backyard” and “each of [the above nations, along with Bangladesh, Nepal and Pakistan] suffer from migraine more or less to a much higher extent [than] any other countries, so our long-term plan is to make what we create here physically, virtually available to those regions”, he said.

Migraine affects over a billion people globally and is the second biggest cause of disability, he noted.

While “no two migraine patients behave the same way”, they often experience “intense and debilitating symptoms that run over days, such as prodrome, aura, acute attacks and postdrome”, the website said.

They’re also at higher risk for depression and anxiety and can face migraine-related cognitive impairment, particularly around verbal and visuospatial memory and selective attention tasks.

Speaking to the limbic, Professor Wijeratne, who also gets migraines, stressed collaboration was key to ending the disability, stigma and neglect.

Despite its prevalence, the condition remains the one of the “least respected, worst managed and most neglected medical disorders worldwide”, he said.

He hopes AIM’s multidisciplinary approach will help improve management and outcomes — where neurologists diagnose and develop treatment plans for patients; occupational therapists increase self-management skills, physical abilities and emotional functioning; and psychologists and psychiatrists handle mental health comorbidities. Further, physiotherapy could potentially reduce musculoskeletal impairments related to neck pain, vestibular symptoms and postural control, while exercise therapy could decrease pain intensity or migraine duration.

Patient and carer input is also critical to honing and ensuring engagement in quality care, he said.

“You can find solutions, but if you don’t get consumers involved in the process, if the consumers are not engaged, they can go to waste,” he said.

Such input included advice that clinics should avoid sun-facing seating arrangements and use colours like green, which has been shown to reduce super-sensitisation of migraine, along with feedback on a community app designed to identify potential migraine patients and encourage them to see a doctor.

It’s anticipated research, education and learnings from the program will aid in evidence-based guideline development and practice and boost migraine expertise among clinicians.

Currently, access to migraine care is a “major issue” in most public and private systems, Professor Wijeratne said.

Getting an appointment with an expert, like in other fields, can take up to two years, and COVID-19 didn’t help, he said.

He hopes the institute will spark greater interest and collaboration in migraine amongst Australian neurologists, adding that their only competition should be against the disorder.

“This is all about connecting dots and bringing the best for patients”, he said.

We’ll see in the coming months how the centre unfolds and patients across Australia start to access the platform physically and virtually, he said.

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