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

Aims and objectives. 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. Relevance to clinical practice. 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.