An Instrument to Assess Patient Perceptions of Satisfaction With Acute Migraine Treatment (EXPERT Study)

Abstract

The new instrument should allow easy identification in general practice of the patients receiving an effective or ineffective acute treatment of migraine and thus facilitate the implementation of treatment guidelines for migraine.

Stability, Responsiveness, and Reproducibility of a Visual Analog Scale for Treatment Satisfaction in Migraine

“…Finally, no attempt was made in this study to validate the VAS rating with some independent measure of treatment satisfaction, which means that artifacts cannot entirely be excluded. However, during the development of the VAS scale, it has been validated against independent satisfaction measures in a large population of migraineurs 17 and, in the present study, there was good concordance between the VAS rating and the HAS criteria for treatment response. In this context, further studies could perhaps be useful to characterize more robustly the psychometric properties of this scale, perhaps looking at long‐term variation in scale metrics, using multimodal assessments, externally validated methods, and a priori identified criterions of performance.…”

“…These thresholds demonstrated high specificity and sensitivity for determining treatment responsiveness according to the HAS criteria (97% and 84%, respectively, for the lower threshold, and 82% and 83%, respectively, for the upper thresholds). In light of these findings, this VAS score appears to offer a practical tool for rapid appraisal of acute treatment response 17 . Further work is however required to validate this VAS for use in everyday practice, in particular with respect to its stability over time and its responsiveness to changes in treatment.…”

“…Given this unsatisfactory situation, it is important that physicians treating patients with migraine take time to assess whether the treatments that they are currently prescribing are actually effective. To this end, we have recently developed a simple visual analog scale (VAS) of treatment satisfaction whose score is associated closely with the HAS criteria for treatment effectiveness 17 . Using receiver operating characteristic curves, scores on this scale were divided into 3 categories predictive of treatment response.…”

“…These are defined as all included patients without a major protocol deviation who attended the study closure visit and completed a VAS, and who provided data on at least 2 headaches in their study diaries. The size of the study samples was determined by a priori power calculations in order to determine the parameters of interest with a precision of 5%, based on previous determinations of the distribution of the VAS score 17 . This provided an estimate of 381 patients for the VASCO cohort and of 359 patients for the ALMO cohort.…”

The Pharmacological Treatment of Migraine in Brazil

“…Reasons for that are unknown, but one might speculate about the lack of commitment with a patient's outcome, even in private environments, as well as the common allegation that a combination of drugs is not underpinned by evidence and decreases adherence, which does not seem to be the reality . Patients with headache may be medicated with nonspecific acute care medications and discharged without a preventive treatment and even a diagnosis, posing a huge burden not only for the patient but for the country's economy as well …”