Abstract

International Headache Classification is now revised based on the evidence accumulated in the last 15 years since the first edition of the classification. Owing to the standardized diagnostic criteria and the introduction of triptans, headache care improved significantly. However, there are many aspects of head- ache care which we are trying to improve in Japan The overall prevalence of migraine in Japan is 8.4%(8 million sufferers). Doctor attendance rate is very low and 69.4% with migraine had never consulted a physician for headache. Only 2.7% is visiting physicians regularly. Yet, 74.2% complained that migraine headache impaired their daily activity signi- ficantly. The loss of disability adjusted life years due to migraine was calculated to be 2.1 years. A large number of migraine sufferers still work during headache attacks of considerable severity, which makes the evaluation by MIDAS scores difficult. The average time required for patients to reach a proper medi- cal care is estimated to be 11 years after the onset and 4 years after the initial visit to a physician for headache. Patients with migraine often do not know if they should consult physician or which phy- sicians to visit This communication is presenting our preliminary data on the effort to establish a clinical path for the patient to reach an appropriate medical care, and to propose an efficient and evidence-based medical procedure. Headache diary was designed to serve as a tool for the patient to give as much information on headache as possible. It should also serve as a prospective history taking to reevaluate headache. The increase in doctor-patient communication should create a mutual participation model. Several experi- mental trials to establish headache center associated with GP-network appear very successful for provi- ding migraine medicine. Korean Journal of Headache 5(1):1-1, 2004