What are the considerations for optimization of acute treatments for migraine attacks?

In primary care, we just don’t have time to get into this. Or do we?

Hi, I’m Dr. Linda Davis. I’m a board-certified family practitioner and Medical Director of Kolvita Family Group in Mission Viejo, CA.

I’ve partnered with AbbVie to talk with you today about the importance of enhancing patient-centric dialogue.

Primary care providers are key to effective management of migraine as they are often the first stop for many patients consulting for headache.

Acute treatment plans should be offered to all patients with migraine and each patient is different.

Identifying the most appropriate acute treatment option and optimal treatment window is important in minimizing the burden of migraine.

It can also minimize the overuse of acute medications which is a risk factor for increasing headache frequency and severity.

Let’s show an example conversation with a patient.

So, do you feel your migraine medication is working when you have an attack?

Yeah; good enough.

Are you taking them as needed?

Yes

Do you want to make any changes?

No; I don’t want to lose the progress I’ve made.

Sounds good.

Let’s now look at opportunities to enhance this dialogue.

How has it been going with your migraine medication when you have an attack?

What do you want to know?

In your own words, just tell me about what it was like when you took it on one of your bad migraine days.

Well, I took the medication, but it didn’t always work very well.

Ok, why do you think it wasn’t working that time?

I think it happens when I sometimes wait until the headache pain is bad enough.

Why are you waiting to treat?

Well, sometimes when I’m doing social events like driving to my son’s birthday last week, I worry about things like side effects, I only get so many a month with my insurance or it doesn’t work fast enough. But I don’t want to make changes and lose the progress I’ve made.

Let’s talk about this further because I don’t want us to settle. There are options we can try to really optimize your treatment plan for when you get a migraine attack.

As you can see, incorporating a few open-ended questions can enhance your collaborative relationship with your patients.

It can be short yet still impactful in coordinating on individual goals for optimizing migraine acute treatments.