Although 12% of the population has migraine, in primary care treatment, it is under-recognized, misdiagnosed, and inadequately treated, according to research.

A study presented at the American Academy of Neurology meeting in April showed that only 28% of primary care providers were aware of the AAN’s guidelines for migraine preventive treatments and 40% knew of the Institutes of Medicine’s Choosing Wisely campaign, which provides migraine treatment recommendations. Medication overuse headache was known to 79% of primary care providers, but only 54% knew that products containing butalbital (Fioricet) can cause MOH and only 34% knew narcotics/opioids can. All this translates into fewer diagnoses and suboptimal care for migraine.

Some facts about migraine treatment in the primary care setting bring home just how unsettling this study’s findings are:

• 95% of all visits to the doctor for headache are with primary care providers
• Headache is the most common neurological symptom presented to general practitioners
• 4% of all adults consult a GP for headache each year
• Of those, 2% are referred to neurologists and 1% are referred to other specialities

I’ll admit my first reaction when someone tells me they have headaches that are disrupting their lives or thinks they have migraine is, “See a headache specialist!” The truth is, that’s often overkill. For most people with migraine, a knowledgeable primary care physician can provide effective care for migraine.

While the study presented at the AAN meeting recommends ways to improve migraine education among primary care providers, the fact is that patients can’t wait. It’s up to patients to ensure they get the best care possible from primary care physicians. If you’re too sick to advocate for yourself, take an ally with you. Our next post will give suggestions on how to maximize your migraine treatment with a primary care provider.

REFERNCES

Minen, M. Tishler, L. Loder, E. Silbersweig, D. (2015) Migraine Diagnosis and Treatment: A Knowledge and Needs Assessment among Primary Care Providers.Poster session presented at the meeting of the American Academy of Neurology, Washington, D.C.

Goadsby PJ. Headache Disorders - not respected, not resourced. All-Party Parliamentary Group on Primary Headache Disorders. 2010. http://www.migrainetrust.org/assets/x/50147