Migraine as a primary care-sensitive condition: Building pathways to accessible care

ObjectiveTo evaluate the eligibility of migraine for classification as a Primary Care-Sensitive Condition (PCSC), and to discuss the public health, clinical, and economic implications of this designation in enhancing access to care across different healthcare systems.BackgroundPrimary Care-Sensitive Conditions are health issues for which timely and effective management in primary care can reduce the need for hospitalization and specialist care. Although migraine is a leading cause of disability worldwide and frequently results in emergency visits and productivity loss, it remains underrecognized in PCSC classifications. This narrative review explores whether migraine fulfills the criteria for PCSC designation and how such recognition may contribute to improved outcomes and system efficiency, particularly in low- and middle-income countries.MethodsWe conducted a narrative review based on the five criteria established by Solberg and Weissman for defining PCSCs: (1) existence of evidence supporting primary care management; (2) public health relevance; (3) diagnostic clarity at the primary care level; (4) potential to avoid hospitalizations through early intervention; and (5) the possibility of hospitalization in severe cases. Global data on migraine epidemiology, diagnosis, treatment, and health system impact were analyzed in this framework.ResultsMigraine fulfills all five criteria for classification as a PCSC. It is highly prevalent and disabling, with substantial economic and social impacts. Diagnosis can be reliably established in primary care using the International Classification of Headache Disorders (ICHD-3) and screening tools like ID-Migraine™, while management is feasible through patient education and preventive strategies. Despite this, underdiagnosis, lack of provider training, and limited access to effective therapies - especially in resource-constrained settings - continue to drive unnecessary hospitalizations. Integrating migraine care into primary care has shown promising outcomes in pilot initiatives globally. Structured interventions, such as professional training and non-pharmacological strategies, have demonstrated cost-effectiveness and improved patient outcomes. Classifying migraine as a PCSC could guide policy reforms, enhance early intervention, and reduce reliance on emergency services.ConclusionMigraine meets criteria for a PCSC and recognizing that offers an opportunity to reframe policy, guide resource allocation and reduce avoidable hospitalizations decreasing the global burden of the disease by promoting timely diagnosis and improving equitable access to care. Strengthening primary care systems and embedding migraine management into routine practice are critical for achieving better health outcomes and more sustainable healthcare delivery.