NICE seeks to improve care for headaches

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Migraine  Headache New NICE quality standards for headache treatment emphasise the need for accurate classification in diagnosis, avoidance of medication overuse, and combination therapy for migraine.

The new quality standards aim to improve the diagnosis and management of headache disorders in people aged 12 and over across the UK, where 25 million working days are lost to these problems each year.

The high incidence of ‘secondary headaches’ due to overuse of painkillers or triptan medicines is a recognised problem within the NHS, and NICE is seeking to raise awareness of this issue.

Types of headache disorder include migraine and tension headaches (primary headaches) and those caused by underlying damage or trauma or by medication overuse (secondary headaches).

NICE recommends that:

• People diagnosed with primary headache disorder should have their headache type classified as part of the diagnosis.

• They should also be given information on the risk of medication overuse, helping them to avoid secondary headaches.

• People with migraine should be offered combination therapy with a triptan and either an NSAID or paracetamol.

Professor Gillian Leng, Director of Health and Social Care at NICE, said: “Headaches and migraine can have a very significant, negative impact upon those who suffer from them. It is important for people to understand that different headaches require different treatments, and so a correct diagnosis is vital.

“People may not know that overusing some types of medication for treating tension-type headaches or migraines can actually make things worse, causing further pain. This standard aims to raise the bar in the care and support for people with headache and migraine.”