title: How general practitioners treat migraine patients: evaluation of a headache guideline.
abstract: OBJECTIVE
  The aim of the study was to evaluate the pharmacological treatment of migraine patients by general practitioners before referral to a neurologist. First, was the pharmacological treatment in accordance with the Dutch College of General Practitioners headache guideline? Second, which migraine characteristics were associated with receiving migraine-specific medication?
  
  
  METHODS
  Migraine patients (age ≥ 18 years) who visited the neurology outpatient clinic for the first time were included. Migraine characteristics and pharmacological status were collected retrospectively for each patient from the general practitioner's referral letter, hospital record and a headache characteristics questionnaire.
  
  
  RESULTS
  A total of 420 migraine patients were included. Only 18.3% of the patients with two or more migraine attacks per month were using prophylactic medication. Furthermore, only 11.7% of patients with symptoms of nausea and/or vomiting were using anti-emetic medication. More than half of patients (51.7%) were using triptans and were likely to have typical migraine symptoms and a long history of migraine.
  
  
  CONCLUSIONS
  Migraine prophylactic medication and anti-emetics are underutilized in the primary care setting for migraine patients in the Netherlands, when compared to the general practitioners guideline. It is important to enhance the knowledge of general practitioners regarding the diagnosis of migraine, and to increase awareness of the headache guideline.
authors: Department of Neurology, Leiden University Medical Center, the Netherlands.
authors: R
authors: R
authors: Zielman
authors: Pjl
authors: P
authors: Veenstra
authors: Ew van
authors: Ev
authors: Zwet
authors: Jsp van den
authors: Jv
authors: Berg
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000700:Analgesics; D000932:Antiemetics