To describe the prevailing opinions of non-neurologists regarding migraine management based on their clinical experience and exposure to scientific data.

Migraine affects nearly 40 million individuals in the United States, more than asthma and diabetes combined.  This surpasses the capacity of neurologists and certified headache specialists.  Emerging knowledge of the pathophysiology of migraine, and the recent availability of targeted migraine therapies may not efficiently migrate to non-neurology settings such as primary care.

A series of advisory boards invited non-neurologists who treat migraine to attend a half-day session.  The general session presented published information on the diagnosis and management of migraine.  Polling questions were administered throughout to identify attitudes and practices related to participants’ management of migraine. Breakout sessions assessed participants’ level of agreement with several statements based on the content that was presented during the general session on a scale of 1 (strongly disagree) to 10 (strongly agree). 

Interim results from 10 advisory boards included 831 registered participants, of whom 823 submitted analyzable breakout session data.  Agreement was lowest for statements that “Migraine is more common that asthma and diabetes combined” (mean 5.9, SD 3.0) and “Migraine is a clearly defined neurological disorder with a known pathophysiology” (mean 6.1, SD 2.8).  Agreement was highest for statements that “Medication regimens should use the minimum number of different medications possible (mean 9.0, SD 1.9) and “For patients with predictable, yet unavoidable triggers, a flexible approach to treat and prevent migraine attacks should be considered” (mean 9.3, SD 1.5)

Non-neurologists value simplicity and flexibility in managing migraine, which they experience as uncommon and complex.  Improving knowledge and education in non-neurology settings may improve population outcomes among patients with migraine.