Clinical determinants of migraine preventive treatment: Contribution of SMILE, an observational survey of primary care migraine management in France

Valade, Dominique; Lantéri-Minet, Michel; Radat, F.; Mekiès, Claude; Lucas, Christian; Vives, Eusebi Chiner; Jm, Joubert; Géraud, G

doi:10.1177/0333102409355661

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Some studies, however, reported a lower frequency of use (25,28). Others have estimated that 5%–83% of migraine patients qualify for preventive treatment (8,10,29). One study in the same population as ours claims much higher numbers for prevention (30).…”

Section: Discussionmentioning

confidence: 99%

Preventive treatment for migraine in primary care, a population-based study in the Netherlands

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Preventive treatment for migraine in primary care, a population-based study in the Netherlands

et al. 2013

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“…The study identified the main comorbidities associated with preventive drug prescription, such as sleep disorders in females, but there are no data on specific treatments and their effects. The French SMILE study assessed the determinants of the prescription of migraine preventive therapy by GPs and neurologists and factors determining eligibility, such as the frequency and severity of headache and scarce evidence of the efficacy of acute treatment [5]. An Italian study evaluating the use of triptans showed that only 21.3% of patients using triptans were under oral preventive treatment or botulin toxin treatment.…”

Section: Introductionmentioning

confidence: 99%

Failure of preventive treatments in migraine: an observational retrospective study in a tertiary headache center

et al. 2020

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Background: Although the criteria for acute migraine treatment and prevention have been well described, there are still unmet needs, general underuse and low benefits of preventive drugs. The aim of the present study was to retrospectively observe the short-term effect of preventive treatment in a cohort of migraine patients attending a tertiary headache center, using data from electronic medical records. Methods: This was an observational retrospective cohort study based on data collected in a tertiary headache center. Data were extracted from an electronic dataset collected from January 2009 to December 2019. The main selection criteria were as follows: age of 18-75 years; diagnosis of migraine without aura (MO), migraine with aura (MA) or chronic migraine (CM); a control visit 3 months after the first access; and prescription of preventive treatment with level of evidence 1 as reported by Italian guidelines. As the primary outcome, we considered the change in the frequency of headache at the follow-up visit. Then, as secondary outcome measures, we used disability scores, intensity of headache, and allodynia. As predictive factors, we considered age, migraine duration, sex, headache frequency, allodynia, anxiety and depression at baseline, and comorbidity with fibromyalgia. Results: Among the 6430 patients screened, 2800 met the selection criteria, 1800 returned to the follow-up visit, 550 withdrew because of adverse events, and 1100 were included the analysis. One hundred thirty-four patients had a frequency reduction of 50% or more. Flunarizine was used for less severe migraine, with a better effect compared to those of other drugs (odds ratio: 1.48; p: 0.022). Low headache frequency and absent or mild allodynia predicted a better outcome. Conclusions: The mild effect of preventive drugs on migraine features and even the number of patients who were lost to follow-up or dropped out because of adverse events confirm that in severe and chronic patients, the first line of prevention can only delay a more focused therapeutic approach.

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“…43 Another study addressed how GPs treated themselves and close relatives; 44 one study explored physicians' understanding of patients with migraine; 45 and another study reports clinical determinants of preventive therapy in primary care. 46 Implications for practice and research Appropriate prophylaxis is an important factor in the aim to improve the quality of care of patients with migraine by reducing attack frequency and duration, improving functioning and productivity, reducing use of acute medication, and preventing medication overuse. The present study has elucidated some factors that prevent GPs from adequately managing migraine from this perspective, and might inform the development of educational strategies to improve migraine prophylaxis in general practice.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Prophylactic treatment of migraine by GPs: a qualitative study

Dekker¹,

Neven²,

Andriesse³

et al. 2012

Br J Gen Pract

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BackgroundDespite the considerable impact of migraine, the use of preventive medication in primary care is limited. Only about 5% of migraine patients who qualify for prophylaxis actually receive it, and adherence is far from optimal. AimTo explore the opinions of GPs regarding preventive medication for migraine. Design and settingA qualitative focus group study in Dutch general practice. MethodFour focus groups (six GPs each) were formed. GPs were purposively sampled to acquire a range of participants, reflecting the more general GP population.

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Clinical determinants of migraine preventive treatment: Contribution of SMILE, an observational survey of primary care migraine management in France

Cited by 6 publications

References 15 publications

Preventive treatment for migraine in primary care, a population-based study in the Netherlands

Preventive treatment for migraine in primary care, a population-based study in the Netherlands

Failure of preventive treatments in migraine: an observational retrospective study in a tertiary headache center

Prophylactic treatment of migraine by GPs: a qualitative study

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