Despite repeated initiatives over the past decade,
migraine remains under-recognised, under-diagnosed and under-treated in everyday clinical practice. The
Migraine in Primary Care Advisors (
MIPCA) group has produced new guidelines for
migraine management to attempt to rectify this situation.
MIPCA is a group of physicians, nurses, pharmacists and other healthcare professionals dedicated to the improvement of
headache management in primary care, who have also worked closely with the
Migraine Action Association (the UK patients' group) in the development of these guidelines. The principles of the new
MIPCA guidelines are: To arrange specific consultations for
headache. To institute a system of detailed history taking, patient education and buy-in at the outset of the consultation. To utilise a new screening algorithm for the differential diagnosis of
headache, which can be confirmed by further questioning, if necessary. To institute a process of management that is individualised for each patient, using a new algorithm. Assessing the impact on the patient's daily life is a key aspect of diagnosis and management. To prescribe only treatments that have objective evidence of favourable efficacy and tolerability. To utilise prospective follow-up procedures to monitor the success of treatment. To organise a team approach to
headache management in primary care.