Criteria for Preventive Treatment in Migraine

In 2004, an expert panel developed recommendations for the use of preventive medication in the treatment of migraine.1

Prevention should
be offered
Prevention should
be considered
Prevention is
not indicated

Prevention Should Be Offered

If the patient reports one of the following:

  • Six or more headache days per month
  • Four or more headache days with at least some impairment
  • Three or more headache days with severe impairment or requiring bed rest

Prevention Should Be Considered

If the patient reports one of the following:

  • Four or five migraine days per month with normal functioning
  • Three migraine days per month with some impairment
  • Two migraine days with severe impairment

Prevention Is Not Indicated

If the patient reports either of the following:

  • Less than four headache days per month and no impairment
  • No more than one headache day per month regardless of the impairment

Goals for Preventive Migraine Treatment

According to the US Headache Consortium there are four goals for preventive treatment.14

  1. Decrease attack frequency by 50% and duration
  2. Improve responsiveness to acute therapy
  3. Improve function and decrease disability
  4. Prevent medication overuse headache and chronic daily headache

Preventive treatment is particularly important for those who experience an impact on their daily lives.1

  • about 45% of patients receiving preventive therapy experience a reduction in monthly frequency of attacks

    45% of patients receiving preventive therapy experience a reduction in monthly frequency of attacks by 50% or more15

  • 38% of people who suffer from migraine could benefit from preventive treatments

    38% of people who suffer from migraine attacks could benefit from preventive treatments16

  • less than 1/3 of those patients appropriate for preventive treatment currently use it

    Less than 1/3 of those patients appropriate for preventive treatment currently use these treatments16


Importance of Continual Assessment

The preventive treatment options currently available have made an impact on patient lives. In fact, patients have seen a 50% reduction in migraine diagnosis-related office and other outpatient visits and an 80% decrease in emergency department visits with a migraine diagnosis.17

However, challenges remain. In fact, less than 20% of patients continued use of certain common oral preventive medications after one year.18 Therefore it is critically important to continually assess your patients' progress against their personalized goals and consider various approaches.

Access the downloadable resource below to learn more about the challenges associated with patient adherence and persistence.

Go to Patient Assessment