This study investigated the use of prophylactic treatment among patients with migraine. It was a cross-sectional survey conducted in three general practices with five GPs, targeting patients aged 18-65 diagnosed with migraine. A questionnaire was sent to 283 patients, with 166 completing it. Of these, 129 were female and 22 male, with a median age of 41 years. Most patients (66.2%) had two or more migraine attacks per month. Fifty-five percent of these patients wanted to use prophylaxis, but only 8% actually used it. The study found that the frequency, duration, severity, and impact of migraine attacks were associated with the willingness to consider prophylaxis. Patients with a higher disease burden, as measured by the Headache Impact Test (HIT6), were more likely to want prophylaxis. Most patients felt confident to ask their GP about prophylaxis, but a significant group preferred their GP to initiate discussions. The study found that frequency of migraine attacks was the strongest independent determinant of the desire for prophylaxis. Patients who opposed prophylaxis cited fear of side effects, minimal attack frequency, and feeling like they had a chronic disease as reasons. The study highlights the need for further qualitative research into patient motivations and the role of GPs in promoting prophylactic treatment. The findings suggest that GPs can play a more active role in optimizing migraine therapy for their patients, as many experience disability and work absence. The study also notes that those who completed the questionnaire had a higher disease burden, which may have led to an overestimation of the percentage of patients wishing to use prophylaxis. The study's findings align with existing literature, indicating that patients often do not consult their GP for headache symptoms but still desire more help.This study investigated the use of prophylactic treatment among patients with migraine. It was a cross-sectional survey conducted in three general practices with five GPs, targeting patients aged 18-65 diagnosed with migraine. A questionnaire was sent to 283 patients, with 166 completing it. Of these, 129 were female and 22 male, with a median age of 41 years. Most patients (66.2%) had two or more migraine attacks per month. Fifty-five percent of these patients wanted to use prophylaxis, but only 8% actually used it. The study found that the frequency, duration, severity, and impact of migraine attacks were associated with the willingness to consider prophylaxis. Patients with a higher disease burden, as measured by the Headache Impact Test (HIT6), were more likely to want prophylaxis. Most patients felt confident to ask their GP about prophylaxis, but a significant group preferred their GP to initiate discussions. The study found that frequency of migraine attacks was the strongest independent determinant of the desire for prophylaxis. Patients who opposed prophylaxis cited fear of side effects, minimal attack frequency, and feeling like they had a chronic disease as reasons. The study highlights the need for further qualitative research into patient motivations and the role of GPs in promoting prophylactic treatment. The findings suggest that GPs can play a more active role in optimizing migraine therapy for their patients, as many experience disability and work absence. The study also notes that those who completed the questionnaire had a higher disease burden, which may have led to an overestimation of the percentage of patients wishing to use prophylaxis. The study's findings align with existing literature, indicating that patients often do not consult their GP for headache symptoms but still desire more help.