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Quality standards for headache treatment issued by NICE

The National Institute for Health and Care Excellence has issued standards to improve the care and support for young people and adults who suffer headache, including migraine.

It covers both primary headaches – such as tension-type headaches or migraine attacks – and also secondary headaches – those caused by underlying disorders and medication overuse.

The NICE quality standard is based on the NICE clinical guideline on headaches, and is designed to improve the diagnosis and management of headache disorders in people aged 12 years and older.

It states that people diagnosed with primary headache disorder should have their headache type classified as part of the diagnosis, so they receive appropriate treatment and prevention for their particular headache.

However, NICE noted that some people will have more than one type of headache and therefore may have more than one classification.

The quality standard also says people with primary headache disorder should be given information on the risk of medication overuse headache, which may prevent secondary headaches.

In addition, those with migraine should be offered combination therapy with a triptan and either an non-steroidal anti-inflammatory drug or paracetamol.

Professor Gillian Leng, NICE deputy chief executive and director of health and social care, said: “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.”

She added: “This standard aims to raise the bar in the care and support for people with headache and migraine.”

Joanna Hamilton-Colclough, director of Migraine Action, endorsed the quality standard.

She said: “We believe the standard is essential as part of the continuing process of recognising the huge impact of headache, both on individuals and wider society, and ensuring those affected are informed about and have access to the most appropriate treatments based on current evidence.”

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