Des consultations dédiées à la migraine en médecine générale Volume 10, numéro 6, Juin 2014

Faculté de médecine Jacques Lisfranc, Département de médecine générale, 42023 Saint-Étienne cedex 2, France rodolphe.charles@univ-st-etienne.fr

Background. Migraine is a common and under-diagnosed pathology in adults and children. Analysis of practice among peers groups (GAPP) seems conducive to the implementation of an innovative experience of developing and testing a useful guideline/questionnaire useful for a general practice consultation dedicated to migraine. Method. Our prospective qualitative study was conducted from May to November 2012 in two GAPP in the Loire County. Three sessions were offered to participants for analysis of their clinical cases, critical reading of documents and preparation of a consultation form. Results. Most of the twenty physicians of the study knew the epidemiological burden of migraine and were intuitively following axes of recommendations, but neglected some notions on headaches, especially on drug abuse. The analysis of the last meeting showed a change in the management of these patients. Consultation dedicated to migraine seemed relevant despite several obstacles, first for the physician (lack of time for extensive consultation, or a renewed one) and then for the patient. Discussion. There still seems to be collusion between the fatalism of patients and the doctors, promoting a shift towards hospital consultations for pain. Disciplinary group reflection on the place of the doctor allowed the production of a tool bringing headache forward during consultation in general practice.