Headache patients can be challenging to see for follow-up visits as often, the headache condition is not the only reason for the appointment. Headache, especially migraine, is comorbid with depression, fibromyalgia, sleep disorders, obesity, and childhood maltreatment, to list just a few. Given the constraints imposed by today’s 15-minute limit for follow-up appointments, it can be a challenge to cover all the clinical bases.
For example, a headache patient may come in to talk about hormones or depressive symptoms and while in the exam room, ask for a refill of their bultalbital, hydrocodone, or a triptan medication. Perhaps there is not much time left in the appointment and the provider would like to assess how the patient is doing before writing the refill.
There are many questions that can help focus the appointment time and provide information to guide the refill decision; which ones to ask will depend on the specific patient and how familiar the clinician is with their headache presentation. Here are 3 very important questions that may not be top of mind in the primary care setting and that can help clarify the patient’s clinical situation and medication needs.
First: Ask about headache days -- not just number of headaches>>>