Original Title: Traitement de la migraine chez l’adulte

Authors' objectives: To improve the tools available to primary care practitioners to treat migraine, the Association des neurologues du Québec commissioned the Institut national d’excellence en santé et en services sociaux to develop a clinical tool for migraine treatment, which was approved by the ministère de la Santé et des Services sociaux.

Authors' results and conclusions: RESULTS (#1 INFORM HEALTHCARE PROFESSIONALS ABOUT AVAILABLE TREATMENT OPTIONS AND THEIR USE): To support clinicians in their choice of treatment, this clinical tool includes: 1) a general algorithm to clarify the sequence of use of the various treatment options, 2) tables outlining the usage conditions of the molecules that have been shown to be effective in treating migraine, including certain factors to consider when choosing them. (#2 PROMOTING SHARED DECISION-MAKING): The clinical tool therefore emphasizes the importance of the discussion when choosing treatment and also includes, in an appendix, several points to be addressed in this discussion in order to keep the person well informed and thus facilitate shared decision-making while promoting their commitment to treatment. (#3 FACILITATING THE MAINTENANCE OF PRIMARY CARE FOLLOW-UPS): Access to more specialized care can sometimes be more difficult, resulting in delays of treatment for people living with migraine. To optimize primary care management and limit specialized consultations to situations that require them, the clinical tool first clarifies the objectives of migraine treatment as well as the criteria for success and failure to be considered in order to ensure an adequate transition between treatments and facilitate primary care follow-up. CONCLUSION: Without replacing clinical judgment, this clinical tool should support practice, particularly by providing information and benchmarks related to available pharmacological treatments, their use, and the situations that require the advice of a medical specialist. However, the potential benefits will depend on the diffusion of the clinical tool associated with this report, as well as the adoption of clinical information and recommendations by the concerned healthcare professionals.

Authors' recommendations: Following the iterative process and triangulation of the information gathered, a series of findings and recommendations were formulated. They are presented in this report and are also included in the clinical tool. They are primarily intended for primary care health professionals, including family physicians, nurse practitioners, and pharmacists.

Authors' methods: To fulfill the mandate, a rapid review of best clinical practices for migraine treatment was conducted based on publications listed in bibliographic databases and other sources of information. The information was analyzed from the perspective of contextualizing Quebec practice, based in particular on legislative, regulatory, and organizational factors specific to Quebec and on the perspectives of the various stakeholders consulted. To gather the perspectives of stakeholders, an advisory committee made up of clinicians from different specialties and areas of expertise was created, and a consultation with people living with migraine was conducted. Finally, external readers who are specialists in the field of interest, as well as future users who did not participate in the work, assessed the overall quality, acceptability, and applicability of the work.

Project Status: Completed

Year Published: 2025

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/traitement-de-la-migraine.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)