THE DOCTOR AND THE MIGRAINE PATIENT - IMPROVING COMPLIANCE

Migraine is an underdiagnosed and undertreated disorder. This can be a ttributed to the low consultation rate for migraine, for which many re asons have been proposed. These include the fact that many migraineurs self-treat and, historically, the lack of available effective treatme nts. Some migraineurs are referred to specialist centers for advice. T hese patients do not merely need effective pain relief. They also need an explanation of the cause of the migraine and reassurance that thei r headache pain does not have a more sinister cause. By spending time with patients and taking a full history of their migraine condition, t he physician can propose a management strategy that is appropriate to each individual patient, thus providing a tailored-care approach. Thor ough exploration of possible trigger factors for migraine and advice o n avoidance may help to reduce attack frequency. Simple techniques can also be used to improve compliance with prescribed therapies. For exa mple, it is important for the physician to establish that the patient understands any instructions given and to reinforce this advice at fol low-up visits. Regular follow-up is important because it enables manag ement strategies to be evaluated and helps the patients to feel involv ed in the management of their migraine. A correct understanding of the way a drug works and the nature of the condition, together with an ex planation of any potential side effects, is likely to maximize clinica l benefit.