Nurses improve migraine management in primary care.
BACKGROUND
Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve the treatment of migraine patients compared to usual care as provided by the GPs.


METHODS
We conducted a non-randomized controlled prospective trial in 235 patients diagnosed with migraine with or without aura according to ICHD-II criteria, aged between 18 and 65 years. Patients with migraine treated only by their GP were compared to management by a nurse supervised by a GP.


RESULTS
In the intervention group, fewer migraine patients were referred to a neurologist (p < 0.001). The reduction in monthly migraine days compared to baseline was more apparent in the intervention group at six (p = 0.09) and nine months (p = 0.006). There was no significant change in dichotomized HIT score (p = 0.076). Change in satisfaction of patients did not differ significantly (p = 0.070).


CONCLUSIONS
The care administered by a headache nurse in the primary care setting supervised by a GP resulted in fewer referrals to the neurologist and more migraine-free days per month, but no change in HIT score. There was no difference in satisfaction scores between both groups.
Department of Neurology, University of Groningen, The Netherlands Department of Neurology, Isala, The Netherlands p.j.l.veenstra@umcg.nl.
Petra
P
Veenstra
Department of General Practice, University of Groningen, University Medical Centre, The Netherlands.
Boudewijn J
BJ
Kollen
Department of Neurology, Isala, The Netherlands.
Gosse
G
de Jong
Schola Medica, Training Institution for Family Practice, The Netherlands.
Frans
F
Baarveld
Department of Neurology, Isala, The Netherlands.
Js Peter
JP
van den Berg
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000451:nursing*; D059408:Pain Management / Q000379:methods*; D059017:Primary Care Nursing / Q000379:methods*
Migraine; general practitioner; nurse; referral; treatment