Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Psychosocial factors and patient-provider interactions associated with procedural migraine care: A cohort of 23,163 patients from the NIH All of Us Research Program.
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Parekh Hiren N, Colakoglu Salih, Reddy Sashank K
Аннотация
BACKGROUND: Procedural therapies, including chemodenervation and nerve-targeted surgery, are increasingly used for refractory migraine. However, nonclinical factors associated with escalation to procedural care remain incompletely understood.
METHODS: A retrospective cohort study was conducted using data from the National Institutes of Health All of Us (NIH AoU) Research Program Registered Tier dataset (version 8). Adults with a documented diagnosis of migraine were identified and classified based on receipt of procedural migraine treatment within 1 year of diagnosis. Patient-reported measures were derived from NIH AoU The Basics and Social Determinants of Health (SDOH) surveys, focusing on psychosocial stress, emotional well-being, and patient-provider interactions. Multivariable logistic regression was performed to estimate the adjusted odds ratios (ORs) for receipt of procedural migraine treatment, controlling for age, sex, and race.
RESULTS: Among 23,163 adult patients, 458 (2.0%) received procedural migraine treatment within 1 year of diagnosis. In adjusted analyses, higher perceived psychosocial stress (OR, 1.48; 95% confidence interval [95% CI], 1.21-1.82), frequent emotional withdrawal (OR, 1.47; 95% CI, 1.10-1.95), and patient-reported negative patient-provider interactions (OR, 1.35; 95% CI, 1.09-1.69) were significantly associated with receipt of procedural migraine treatment. Demographic factors, including age, sex, and race, were not significantly associated with treatment utilization after adjustment.
CONCLUSION: Psychosocial distress and patient-provider interactions are associated with receipt of procedural migraine treatment, likely reflecting disease burden and care complexity rather than differential access. Leveraging the granularity of patient-reported survey data within the NIH AoU Research Program highlights the potential of next-generation datasets to advance patient-centered research in plastic and reconstructive surgery.
METHODS: A retrospective cohort study was conducted using data from the National Institutes of Health All of Us (NIH AoU) Research Program Registered Tier dataset (version 8). Adults with a documented diagnosis of migraine were identified and classified based on receipt of procedural migraine treatment within 1 year of diagnosis. Patient-reported measures were derived from NIH AoU The Basics and Social Determinants of Health (SDOH) surveys, focusing on psychosocial stress, emotional well-being, and patient-provider interactions. Multivariable logistic regression was performed to estimate the adjusted odds ratios (ORs) for receipt of procedural migraine treatment, controlling for age, sex, and race.
RESULTS: Among 23,163 adult patients, 458 (2.0%) received procedural migraine treatment within 1 year of diagnosis. In adjusted analyses, higher perceived psychosocial stress (OR, 1.48; 95% confidence interval [95% CI], 1.21-1.82), frequent emotional withdrawal (OR, 1.47; 95% CI, 1.10-1.95), and patient-reported negative patient-provider interactions (OR, 1.35; 95% CI, 1.09-1.69) were significantly associated with receipt of procedural migraine treatment. Demographic factors, including age, sex, and race, were not significantly associated with treatment utilization after adjustment.
CONCLUSION: Psychosocial distress and patient-provider interactions are associated with receipt of procedural migraine treatment, likely reflecting disease burden and care complexity rather than differential access. Leveraging the granularity of patient-reported survey data within the NIH AoU Research Program highlights the potential of next-generation datasets to advance patient-centered research in plastic and reconstructive surgery.