Abstract
Background
Clinical guidelines agree that preventive treatment should be considered in patients with uncontrolled migraine despite acute medications or patients with ≥4 migraine days per month. However, the criteria to define the effectiveness of treatment and the factors that inform the decision to (dis)continue it are not clearly defined in clinical practice.
Methods
Overall, 148 healthcare practitioners from 5 European countries completed a 2-wave questionnaire. The Steering Committee defined a simulated set of 108 migraine patient profiles based on the combination of 5 factors (frequency of the attacks, intensity of the attacks, use of acute migraine medications, patient perception, and presence/absence of tolerable side effects). These profiles were used in a Delphi survey among European neurologists to identify the criteria that should be used to decide treatment response and continuation using a conjoint analysis approach.
Results
Consensus was reached for 82/108 (76%) of profiles regarding treatment response, and for 86/108 (80%) regarding treatment continuation. Multivariable logistic regression analysis showed that a ≥50% reduction in the use of acute migraine medications and positive patient perception of treatment were the most important factors that lead to the decision of continuing (combined factors, OR=18.3, 95% CI 13.4-25.05).
Conclusions
This survey identifies two relevant outcome measures: one objective (use of acute migraine treatment medications) and one subjective (positive patient perception) that guide the clinician decision to continue preventive treatment in migraine patients.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/3gTSDce
via IFTTT
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