Did you know that migraine is ranked 2nd among all health disorders in terms of years lived with disability by the Global Burden of Disease? Vos, T, Abajobir, AA, Abate, KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390:1211–59
The Canadian Headache Society recently released new guidelines related to the treatment of migraine which address appropriate medication management of episodic, frequent episodic and chronic migraine. Updated Canadian Headache Society Migraine Prevention Guideline with Systematic Review and Meta-analysis | Canadian Journal of Neurological Sciences | Cambridge Core
Migraine is generally considered to be a chronic condition and as such there is an important role for primary care nurses to play in the care of patients suffering from migraine.
So...how can we get started?
Using a migraine tracker like the one available for free through Canadian Migraine Tracker – The EASY way to keep a diary! can be an awesome tool to help you better understand individuals living with migraine and facilitate comprehensive care.
Medication induced headache (previously referred to as medication overuse headache) is a common challenge in migraine management and yet many people aren't aware of what this means.
Medications frequently used to treat headaches including triptans, NSAIDS and acetaminophen can actually contribute to headaches if taken too frequently.
Current data suggest that taking any of these medications more than 2-3 days per week can lead to medication induced headache. Interestingly, opioid containing medications may cause this complication with even less frequent use.
Awareness and support around appropriate medication use andidentifying the need to explore other treatment options is a great area for nursing lead care. There are some new classes of medication available that they may not be aware of, which couldoffer an opportunity to discuss and collaborate with their primary care provider.
Another important aspect of migraine management is teaching and support for lifestyle interventions.
The same patient centered strategies used to support our patients with other chronic health conditions are incredibly applicable in the context of migraine management.
Lastly, ongoing follow up! Regular review of headache frequency, medication use, side effects and lifestyle management can allow you to identify needs and continue to support your patients in managing migraine effectively.
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