Migraine Management Unmet Needs

Patient Education and Expectations

The American Academy of Neurology implies that patients commonly misconceive that migraine treatment should eliminate attacks entirely, when the realistic objective is returning control from the disease to the patient by reducing attack frequency, duration, and pain intensity to minimize life disruption 1
The American Headache Society suggests that non-adherence remains a major obstacle requiring time-intensive education about correct medication use, potential adverse effects, and the critical importance of avoiding medication overuse 1
The National Institute of Neurological Disorders and Stroke indicates that time constraints in clinical practice prevent adequate patient education, though freely available patient information leaflets can partially address this gap 1

The American Academy of Neurology recommends that no a priori basis exists for selecting optimal acute therapy for individual patients, forcing reliance on trial-and-error stepped care approaches 1

The International Headache Society states that medication overuse headache represents a devastating unmet need, with patients using acute medications more than twice weekly developing increasing headache frequency that can progress to daily headaches 1, 2

The American College of Physicians suggests that preventive therapy is underutilized despite clear indications: two or more attacks per month producing disability lasting 3+ days, use of abortive medication more than twice weekly, or failure of acute treatments 3
The American Academy of Neurology indicates that clinical benefit from preventive medications requires 2-3 months to manifest, yet patients and clinicians often discontinue therapy prematurely before adequate trials 3

The American Heart Association implies that coexisting conditions limit treatment choices but systematic approaches to managing these constraints are lacking, according to the guideline society 4