(Opinion) Migraine advocacy on Capitol Hill

What it means for New Hampshire patients and their families

HEALTH CARE

By: Priyanka Shekhawat

Migraine is one of the most common and disabling neurologic diseases, yet its impact is still underestimated in everyday health conversations.

For patients and families, migraine is not simply an occasional headache; it is a recurrent neurologic condition that can disrupt school attendance, work stability, family life and overall functioning.

Advancing migraine care requires more than good medications alone. It depends on coordinated advocacy, cross-disciplinary collaboration and sustained engagement from the medical community.

As a neurologist in New Hampshire specializing in headache and autonomic disorders, I see firsthand how disabling and heterogeneous migraine can be. While many patients receive effective, evidence-based treatment, others face delays in diagnosis or barriers to timely therapy.

These differences usually stem from the complexity of migraine and broader system factors — including specialty availability, insurance and access structures, and care coordination — rather than individual clinical effort. Improving migraine outcomes requires coordinated work beyond the exam room.

Advocacy leaders have emphasized that much of migraine’s burden remains unseen. As Olivia Begasse De Dhaem, MD, FAHS, Advocacy Committee co-chair of the American Headache Society, has noted, “Most migraine-related productivity loss comes from presenteeism — people working during an attack but functioning at only 50%.” That hidden burden helps explain why migraine is often underestimated and why many patients hesitate to disclose their condition or request support.

This month, I will join patients and advocates from New Hampshire in traveling to Washington, D.C., to participate in “Headache on the Hill,” a national advocacy event organized by the Alliance for Headache Disorders Advocacy (AHDA).

The goal is to bring front-line clinical perspective and patient experience directly into conversations with lawmakers on Capitol Hill — highlighting the real-world impact of migraine and the need for stronger policy support for research, access and care. When decision-makers hear from patients and the physicians who treat them, migraine becomes visible for what it is: a serious neurologic disease that warrants structured, evidence-based policy attention.

This work is part of my broader professional advocacy efforts. As an active member of the American Academy of Neurology (AAN), I participate in nonpartisan advocacy work aimed at improving neurologic and brain health outcomes. I also work closely with the New Hampshire Chapter of the American Academy of Pediatrics (NH AAP). With encouragement and leadership support from NH AAP president Christine Arsnow, M.D., FAAP, advocacy linking pediatric and neurologic health priorities such as migraine continues to expand across New Hampshire. This approach also supports practical tools such as school migraine action plans and accommodation letters.

Migraine care especially benefits from collaboration across specialties. Children with migraine may first present to pediatricians or school health systems. Adults may be seen in primary care, emergency settings or specialty clinics.

Patients with complex symptoms may cross into neurology, cardiology, behavioral health, rehabilitation and pain medicine.

Coordinated communication among these groups improves diagnostic accuracy and treatment consistency. Advocacy that reflects this shared responsibility is more effective than siloed messaging.

Migraine advocacy efforts nationally focus on improving access to evidencebased treatments, reducing administrative barriers, strengthening research investment, and expanding care pathways for high-impact populations such as youth and veterans.

Migraine is both common and complex.

For patients and families in New Hampshire, migraine advocacy helps determine how — and how quickly — patients can access care and supportive resources. When medical societies, frontline clinicians Improving migraine care depends on building better connections — between specialties, between clinicians and policymakers, and between today’s physicians and the next generation. Advocacy is how that progress continues.

Priyanka Shekhawat, M.D., FAAP, is a NH-based neurologist, and is an assistant professor of neurology at the University of New England College of Osteopathic Medicine, and a state captain for Headache on the Hill national advocacy event 2026.