Nurses improve migraine management in primary care.

Area of Science:

• Neurology
• Primary Care
• Nursing

Background:

• Migraine is a prevalent neurological disorder with a significant impact on quality of life.
• General practitioners (GPs) primarily manage migraine, but treatment optimization is needed.
• This study explores the role of primary care nurses in enhancing migraine management.

Purpose of the Study:

• To evaluate if primary care nurses can improve migraine treatment outcomes compared to usual GP care.
• To assess the impact of nurse-led care on patient referrals, migraine frequency, and treatment satisfaction.

Main Methods:

• A non-randomized controlled prospective trial involving 235 adult migraine patients.
• Comparison between patients managed solely by GPs and those managed by a GP-supervised nurse.
• Diagnosis adherence to International Classification of Headache Disorders, 2nd Edition (ICHD-II) criteria.

Main Results:

• Fewer patients in the nurse-led group were referred to neurologists (p < 0.001).
• A greater reduction in monthly migraine days was observed in the intervention group at 6 and 9 months (p=0.09, p=0.006).
• No significant changes were found in the dichotomized HIT score (p=0.076) or patient satisfaction (p=0.070).

Conclusions:

• GP-supervised headache nurses in primary care reduce neurologist referrals and increase monthly migraine-free days.
• While effective in reducing referrals and improving migraine frequency, nurse-led care did not significantly alter HIT scores or patient satisfaction.
• This model suggests a valuable role for nurses in optimizing primary care for migraine patients.