Compliance with practice guidelines by primary care physicians has historically been poor. Mechanisms such as the use of patient problem lists and diabetic flow sheets can serve as reminders to physicians and can facilitate closer adherence to practice guidelines. Prioritizing treatment according to headache severity and associated symptoms will help the physician determine the most appropriate medications to use. Narcotics should be reserved for use only in patients unresponsive to adequate trials of non-narcotic agents. Sumatriptan and dihydroergotamine are more expensive than other migraine agents but have distinct therapeutic advantages in patients with moderate to severe headaches.
Some patients experience rebound headache from overuse of analgesics and other headache medications.
Educating patients about self-help measures and avoidance of triggers is an important element in the effective management of migraine headaches. All of these factors should influence the physician's interview techniques and use of resources. Copyright 1997 by the American Academy of Family Physicians. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.