Study Evaluates Unmet Needs of People with Episodic Migraine
We all know that people with Migraine have needs that aren't met. In recent years, much of the attention has been focused on chronic Migraine (CM), which is understandable given its impact. Still, patients with episodic Migraine (EM) far outnumber those with chronic Migraine.
Recently, researchers reviewed data from the American Migraine Prevalence and Prevention Study (AMPP) and published the data of their study with the objective:
"To determine the relative frequency of prespecified types of 'unmet treatment needs' in persons with EM in a US population-based sample."
The researchers identified five areas of unmet treatment need:
- dissatisfaction with current acute treatment,
- moderate or severe headache-related disability.
- excessive use of opioids or barbiturates.
- recurrent use of the emergency department or urgent care clinic, and
- history of cardiovascular events indicating a possible contraindication to triptan use.
They found that 40.7% (of 5,591 study participants) had one or more unmet needs:
- 26.2% had 1 unmet need, and
- 14.4% had 2 or more unmet needs.
Among study participants with at least one unmet need:
- 47.0% had moderate or severe Migraine-related disability,
- 37.4% were dissatisfied with their acute treatment regimen,
- 32.0% had excessive opioid or barbiturate use and/or probable dependence,
- 26.2% had a history of cardiovascular events, and
- 5.7% reported 2 visits in the preceding year to the emergency department/urgent care clinic for Migraine.
Researchers also noted that study participants who had more Migraine days, depression, or generalized anxiety were more likely to have unmet treatment needs.
The researchers concluded:
"In a population sample of individuals with EM, more than 40% have at least 1 unmet need in the area of acute treatment. The leading reasons for unmet needs, which include headache-related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for persons with EM."
Summary and comments:
With unmet needs of those with EM established, health care professionals can now have more targeted goals for treatment of EM. Patients too can work toward meeting these needs for ourselves by working more closely with our health care team as treatment partners. No, we don't want to make unrealistic demands, but there IS a happy medium in which we carefully maintain our Migraine diaries and discuss our acute treatments with our team in an honest and open manner. We need to be able to not only tell our team that our needs are unmet; we need to be able to give them specifics so we can all work together to meet those needs.
Lipton, Richard B., MD; Buse, Dawn C., PhD; Serrano, Daniel, PhD; Holland, Starr, PhD; Reed, Michael L., PhD. "Examination of Unmet Treatment Needs Among Persons With Episodic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study." Headache. Early View. Accepted for Publication April 26, 2013.
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