Migraine and chronic daily headache management: implications for primary care practitioners. 2007

Michele Peters, and Vasso Vydelingum, and Huda Huijer Abu-Saad, and Andrew Dowson
European Institute of Health and Medical Sciences, Duke of Kent Building, University of Surrey, Guildford, Surrey, UK.

OBJECTIVE The aim of this paper is to outline the classifications of migraine and chronic daily headaches (i.e. headaches occurring at more than 15 days per month) and briefly describe their epidemiology and management. After outlining the patients' management behaviours, this review paper discuss the implications for primary care practitioners, including general practitioners and nurses. Finally the paper sets out current resources for headache education for healthcare practitioners. BACKGROUND There is a scarcity of recent literature about migraine and chronic daily headache in primary care and of the evidence base for best practice. Patients with migraine and headache may see a variety of healthcare professionals and may not always be accessing the best sources of help. METHODS Various databases were searched, such as CINAHL, Cochrane, Medline, MedlinePubmed and the BMJ. In addition, manual searches were conducted by following on cited references from papers read. RESULTS The results of the literature reviews were critically read and evaluated by the team and the results are discussed in the critical review presented in this paper. CONCLUSIONS The paper proposes multidisciplinary working in relation to migraine and headache management in primary healthcare, using an evidence-based approach that stresses the importance of making the correct diagnosis, patient focused management and appropriate referrals to appropriate agencies to maximize benefits for patients.

UI MeSH Term Description Entries
D008297 Male Males
D008881 Migraine Disorders A class of disabling primary headache disorders, characterized by recurrent unilateral pulsatile headaches. The two major subtypes are common migraine (without aura) and classic migraine (with aura or neurological symptoms). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1) Acute Confusional Migraine,Headache, Migraine,Status Migrainosus,Abdominal Migraine,Cervical Migraine Syndrome,Hemicrania Migraine,Migraine,Migraine Headache,Migraine Variant,Sick Headache,Abdominal Migraines,Acute Confusional Migraines,Cervical Migraine Syndromes,Disorder, Migraine,Disorders, Migraine,Headache, Sick,Headaches, Migraine,Headaches, Sick,Hemicrania Migraines,Migraine Disorder,Migraine Headaches,Migraine Syndrome, Cervical,Migraine Syndromes, Cervical,Migraine Variants,Migraine, Abdominal,Migraine, Acute Confusional,Migraine, Hemicrania,Migraines,Migraines, Abdominal,Migraines, Acute Confusional,Migraines, Hemicrania,Sick Headaches,Variant, Migraine,Variants, Migraine
D010353 Patient Education as Topic The teaching or training of patients concerning their own health needs. Education of Patients,Education, Patient,Patient Education
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003152 Community Health Nursing General and comprehensive nursing practice directed to individuals, families, or groups as it relates to and contributes to the health of a population or community. This is not an official program of a Public Health Department. Nursing, Community Health
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D020773 Headache Disorders Various conditions with the symptom of HEADACHE. Headache disorders are classified into major groups, such as PRIMARY HEADACHE DISORDERS (based on characteristics of their headache symptoms) and SECONDARY HEADACHE DISORDERS (based on their etiologies). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1) Cephalgia Syndromes,Chronic Headache,Chronic Daily Headache,Headache Syndromes,Headache, Intractable,Cephalgia Syndrome,Chronic Daily Headaches,Chronic Headaches,Daily Headache, Chronic,Daily Headaches, Chronic,Headache Disorder,Headache Syndrome,Headache, Chronic,Headache, Chronic Daily,Headaches, Chronic,Headaches, Chronic Daily,Headaches, Intractable,Intractable Headache,Intractable Headaches,Syndrome, Headache

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