Pharmacists should receive training to ensure they can warn patients suffering with headache about the dangers of medicine overuse, Nice has said. 

Patients taking medication for a primary headache, particularly those with tension-type headaches and migraines, should be made aware that too much medication can cause a secondary headache, Nice said in its quality standard published yesterday (August 28).

Healthcare practitioners, including pharmacists, should provide this information to patients and the government should ensure that those involved in assessing, caring for and treating patients with headache receive "sufficient and appropriate training" to deliver Nice standards, the health watchdog said. 

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	The quality standard, which is based on Nice clinical guidance, also states that patients should have their headache classified as part of their diagnosis, which would ensure they received the appropriate treatment.

"People may not know that using some types of medication for treating tension-type headaches or migraines can actually make things worse, causing further pain," said Nice director of health and social care Gillian Leng.

Consultant neurologist Sam Chong, who helped develop the standards, said he hoped they would go "some way in raising awareness" of medication overuse headaches.

Healthcare practitioners should also advise patients with a migraine to take a combination therapy of triptan with either a non-steroidal anti-inflammatory drug or paracetamol and patients should only be referred for a scan if they have the signs or symptoms of a secondary headache, Nice said. 

Nice quality standards are designed to help commissioners and healthcare professionals to provide measurable improvements in the quality of care within specific areas of health.