• Could Your Patients With Bad Headaches Have Migraine?

    Information provided by Eli Lilly

    Eli Lilly

    Migraine is much more than a bad headache. It’s a common and debilitating disease1 for which primary care physicians are in the unique and pivotal position to help. A study of patients who visited a primary care physician for any reason found 29% of all patients and 37% of women had migraine.2 In another study, up to 94% of outpatients presenting to a clinic with headache were found to have migraine.3*

    For various reasons, many people with migraine are underdiagnosed and undertreated.4-5 Some people with significant disabling headache often do not recognize it as migraine. Others push through the pain or hesitate to talk openly and share their experience with key signs and symptoms of migraine – impact on daily activities, nausea, and sensitivity to light.1 While most patients presenting to your office with headache likely have migraine,3 it can be challenging to ensure proper diagnosis of migraine and determine an optimal treatment plan without direct discussions about how headache is impacting their lives. Fortunately, there is something you can do to help and there are steps you can take to minimize the time constraints often seen in clinical practice.

    Migraine can have a large impact on a person’s life, including negative effects on physical health, social activities, and family life. The next time you have a patient who presents with headache, remember to THINK, TALK, and TREAT migraine. A simple algorithm can help guide conversations about the impact of migraine:

    • THINK: Ask patients whether their headaches have limited their activities, if they experience nausea with their headache, and/or if they are sensitive to light. If your patient’s answer is “yes” to at least two of these questions, it is highly likely they have migraine.6

    • TALK: Discuss with your patients how many days a month they experience headaches that impact their lives. Understanding the frequency and impact of migraine on daily activities can help inform treatment decisions.

    • TREAT: Following diagnosis of migraine, it’s important to treat it early and effectively for best results.6-8 The level of treatment depends on impact to daily activities. For one or more days per month of impact, offer recommendedacute treatment. For four or more days per month of impact, consider recommended acute plus preventive treatment.

    While there is no one-size-fits-all approach to treating migraine, a shared understanding about migraine can help to THINK about, TALK with patients about and TREAT migraine more effectively. For more information and resources, visit ThinkMigraine.com/hcp.

    *Combines International Headache Society-defined migraine (76%) and probable migraine (18%).3

    Recommended medications refer to those with established/probable efficacy as identified by the American Academy of Neurology (AAN)/American Headache Society (AHS) guidelines and the AHS position statement regarding new migraine treatments.9,10

    VV-OTHR-US-DEL-0742 12/2021 ©Lilly USA, LLC 2021. All rights reserved.


    1. The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
    2. Couch J, Taylor K, Hilliard B. Migraine in the primary care population: prevalence, severity, and disability. Presented at: 45th Annual Scientific Meeting American Headache Society; June 19-22, 2003; Chicago, Illinois.
    3. Tepper SJ, Dahlöf C, Dowson A, et al. Prevalence and diagnosis of migraine in patients consulting their physician with a complaint of headache: data from the landmark study. Headache. 2004;44:856-864.
    4. Lipton RB, Bigal ME, Diamond M, et al; for the AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343-349.
    5. Diamond S, Bigal ME, Silberstein S, et al. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache. 2007;47:355-363.
    6. Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine™ validation study. Neurology. 2003;61;375-382.
    7. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache. 2019;59:1-18.
    8. Buse DC, Greisman JD, Baigi K, Lipton RB. Migraine progression: a systematic review. Headache. 2019;59:306-338.
    9. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults. Neurology. 2012;78:1337-1345.
    10. Burch RC, Ailani J, Robbins MS. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;00:1-19.


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