The pillars of migraine diagnosis and treatment: Information from primary care physicians in Colombia

Introduction: Migraine is a highly prevalent and disabling condition, with most patients treated at the primary care level. To the best of our knowledge, no information is available in Colombia regarding the knowledge of migraine among physicians at this level of care. Objective: To determine the proportion of primary care physicians who observe the pillars of migraine diagnosis and treatment in their clinical practice: the International Classification of Headache Disorders (ICHD-3) diagnostic criteria, the indication to start preventive treatment, restriction of analgesic medication, and considering the presence of comorbidities. Material and methods: We conducted a cross-sectional survey of actively practising primary care physicians from all over Colombia using an online semi-structured questionnaire, which was completed by general practitioners, paediatricians, gynaecologists, internists, and family medicine specialists. Results: A total of 347 primary care physicians from all the regions of Colombia were surveyed; 23.2% used the ICHD-3 criteria, 49% and 85% were familiar with the Colombian guidelines for starting preventive treatment and limiting analgesic medication overuse, respectively; 61% never considered opioids for acute attacks; and 80% took comorbidities into account in their clinical approach. The compliance index for the main pillars of migraine care was 52%. We found no significant differences when specialty, length of time in practice, age, and area of work were compared. Conclusion: This study suggests that there is limited knowledge about migraine among Colombian primary care physicians. These results are comparable with similar studies conducted around the world.