| Summary: | The article focuses on the challenges and strategies for implementing the 2025 American Headache Society (AHS) consensus guidelines for acute migraine treatment in emergency departments (EDs). Despite evidence-based recommendations such as intravenous prochlorperazine and occipital nerve blocks being designated as Level A–Must offer interventions, their uptake in ED practice remains inconsistent due to multifaceted barriers beyond lack of knowledge. The article advocates for the use of implementation science, specifically the Expert Recommendations for Implementing Change (ERIC) taxonomy, which offers a structured, phased approach involving stakeholder engagement, local adaptation, and systemic changes to bridge the gap between guidelines and real-world practice. It emphasizes that successful implementation requires multimodal strategies tailored to local contexts, including education, clinical decision support tools, patient involvement, and policy-level support to sustain evidence-based migraine care in emergency settings.
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