• Proactive long-term follow-up procedures should be instigated for all migraine patients:
  
  
  • A headache diary should be used to capture the patient's pattern of headaches over time.
    
    
  • Impact questionnaires (MIDAS and HIT) can capture the impact of migraine over time and may also be useful in assessing the response to therapy.
    
    
  • The practice nurse can often collect this information.
    
    
• Patients who do not respond to repeated courses of acute and prophylactic medications should be referred to a neurologist or headache specialist for care.

The New MIPCA Algorithm for Migraine Management in Primary Care

http://www.medscape.com/viewarticle/446557_10