Headache Care for Practising Physicians (HCPC) Guidelines

The Headache Care for Practising Clinicians (HCPC) group is an independent organisation working through research and education to improve the management of headache by practising clinicians worldwide. HCPC includes any healthcare providers with an interest in headache, including physicians, nurses, pharmacists and other practitioners.

Twelve principles of migraine management have been identified by HCPC. Of these, ten relate to the management and treatment of migraine.^[1]

Management

• Share migraine management with the patient.
• Provide individualised care for migraine and encourage patients to manage their migraine.
• Follow up patients, preferably with migraine calendars or diaries.
• Regularly re-evaluate the success of therapy using specific outcome measures, and monitor the use of acute and prophylactic medications regularly.
• Adapt migraine management to changes that occur in the illness and its presentation over the years.

Treatment

• Provide acute medication to all migraine patients and recommend it is taken at the appropriate time during the attack.
• Provide rescue medication/symptomatic treatment for when the initial therapy fails.
• Offer to prescribe prophylactic medications, as well as lifestyle changes, to patients who have four or more migraine attacks per month or who are resistant to acute medications.
• Consider concurrent co-morbidities in the choice of appropriate prophylactic medications
• Work with the patient to achieve comfort with the treatment that has been mutually agreed upon, and ensure that it is practical for their lifestyle and headache presentation.

The full HCPC guideline document can be accessed by clicking here.

Reference:
1. Dowson AJ, Sender J, Lipscombe S, Cady RK, Tepper SJ, Smith R, et al. Establishing principles for migraine management in primary care. Int J Clin Pract 2003;57: 493-507.