. 2024 Aug 19;25(1):134. doi: 10.1186/s10194-024-01834-y

Table 1.

Criteria for traversing barriers to care by country

Barrier	Criteria
Barrier	US	Canada	Germany	France	UK	Japan
Appropriate current consulter^a	GP, family physician, or IM doctor	GP, family physician, or IM doctor	GP, family physician, or IM doctor	GP, family physician, or IM doctor	GP, family physician, or IM doctor	GP, family physician, or IM doctor
	NP or PA	NP or PA	NP or PA	-	Clinical NP	-
	Allergist	Allergist	Allergist	Allergist	Allergist	Allergist
	ENT	ENT	ENT	ENT	ENT	ENT
	Headache specialist	Headache specialist	Headache specialist	Headache specialist	Headache specialist	Headache specialist
	Neurologist	Neurologist	Neurologist	Neurologist	Neurologist	Neurologist
	Ob-Gyn	Ob-Gyn	Ob-Gyn	Ob-Gyn	Ob-Gyn	Ob-Gyn
	Pain specialist	Pain specialist	Pain specialist	Pain specialist	Pain specialist	Pain specialist
	-	Ophthalmologist^b	-	Ophthalmologist^b	Ophthalmologist^b	Ophthalmologist^b
	Psychiatrist	Psychiatrist	Psychiatrist	Psychiatrist	Psychiatrist	Psychiatrist
	-	PM&R physician^b	-	-	-	-
	-	-	Orthopedic physician^b	Orthopedic physician^b	-	-
	-	-	-	Rheumatologist	-	-
Accurate diagnosis	< 15 MHDs, diagnosis = migraine or menstrual migraine ≥ 15 MHDs, diagnosis = chronic migraine or transformed migraine
Appropriate treatment^c	Acute treatment (for any respondent with a diagnosis of migraine^d)
	NSAID	NSAID	NSAID	NSAID	NSAID	NSAID
	Triptan	Triptan	Triptan	Triptan	Triptan	Triptan
	Ergotamine	Ergotamine	Ergotamine	Ergotamine	Ergotamine	Ergotamine
	Isometheptene	-	-	-	Isometheptene	-
	Ditan^e	-	-	-	-	Ditan^e
	Gepant^f	-	-	-	Gepant^f	-
	-	-	-	Combo Rx^g	-	-
	-	-	-	-	-	Other Rx analgesic^h
	Preventive treatment (AHS Consensus Statement used to define need for preventive treatmentⁱ)
	Anti-seizure	Anti-seizure	Anti-seizure	Anti-seizure	Anti-seizure	Anti-seizure
	Anti-depressant	Anti-depressant	Anti-depressant	Anti-depressant	Anti-depressant	Anti-depressant
	Calcium channel blockers and other anti-hypertensives	Calcium channel blockers and other anti-hypertensives	Calcium channel blockers and other anti-hypertensives	Calcium channel blockers and other anti-hypertensives	Calcium channel blockers and other anti-hypertensives	Calcium channel blockers and other anti-hypertensives
	Toxin injections	Toxin injections	Toxin injections	Toxin injections	Toxin injections	-
	Gepant^f	Gepant^f	Gepant^f	-	Gepant^f	Gepant^f
	-	-	-	Other oral preventive	-	-

AHS, American Headache Society; CGRP, calcitonin gene–related peptide; ENT, ear, nose, and throat specialist; GP, general practitioner; HCP, health care professional; IM, internal medicine; MHD, monthly headache day; NP, nurse practitioner; NSAID, nonsteroidal anti-inflammatory drug; Ob-Gyn, obstetrician-gynecologist; PA, physician assistant; PM&R, physical medicine and rehabilitation physician; Rx, prescription; UK, United Kingdom; US, United States

^aHealth care professionals varied by country based on input from headache experts in each respective country. ^bOnly a few patients received care from an ophthalmologist, orthopedic doctor, or PM&R. ^cAppropriate treatment as per AHS guidance. ^dRespondents were excluded if the only acute treatment received was an opioid. ^eDitans were considered appropriate acute treatment in the countries in which they were available at the time of the survey. ^fGepants were considered appropriate treatments in the countries in which they were available at the time of the survey. ^gIncludes acetaminophen + caffeine. ^hIncludes Rx aspirin and Rx acetaminophen. ⁱPer the AHS Consensus Statement, preventive medication for migraine should be offered to people with ≥ 6 MHDs regardless of disability, those with ≥ 4 MHDs with at least mild disability, and those with ≥ 3 MHDs with at least severe disability