Determinants of Patient Satisfaction With Migraine Therapy

Abstract

Determinants of patient satisfaction with migraine treatment are not well understood. The objective of this study was to evaluate which treatment outcomes influence patient satisfaction with treatment. Analyses were performed on data from 1506 migraineurs from two clinical trials of rizatriptan for treatment of migraine. Satisfaction with treatment was assessed 2 h after initial treatment and prior to use of rescue therapy. Over 90% of patients who were pain-free at 2 h were at least somewhat satisfied with treatment compared with <10% of patients with moderate or severe pain. Only 60-70% of patients with mild pain at 2 h experienced some level of satisfaction with treatment. For patients with mild pain at 2 h, results showed subjects who reported severe pain at baseline, absence of associated symptoms at 2 h and pain relief within the first 90 min had at least a 76% probability of being at least somewhat satisfied. This probability decreased with the presence of associated symptoms, slower pain relief and moderate baseline pain intensity. Fast, complete pain relief is one important factor in determining short-term patient satisfaction with treatment.

Treatment preferences and the selection of acute migraine medications: results from a population-based survey

“…Reasons for dissatisfaction were pain relief taking too long (87%), incomplete pain relief (84%), inconsistent relief (84%), headache recurrence (71%), and too many side effects (35%). These results are supported by post-hoc analyses of clinical trials showing that fast and complete pain relief predicts satisfaction and health-related quality-of-life [27][28][29].…”

Meeting Acute Migraine Treatment Needs through Novel Treatment Formulations

“…Orally inhaled DHE has shown promise in phase 3 trials and will likely be available soon for migraine patients. New acute migraine formulations have been shown to achieve more desirable treatment targets of quicker and more complete relief 3 by providing more rapid onset of action, sustained anti-migraine effect, and improved consistency of response.…”

“…When migraineurs are questioned regarding factors that influence acute therapy satisfaction, achieving pain relief in Յ1 h and obtaining complete symptom relief within 2 h were linked to enhanced satisfaction. 3 Why do many current acute therapies fail? New information on migraine pathophysiology can be used to enhance therapy.…”

Do the Endpoints Used in Most Migraine Clinical Trials Adequately Reflect Patients’ Desire for Rapid, Complete, and Sustained Relief of Their Attacks?

“…For more than 20 years, migraine patients have rated rapid onset of action, freedom from headache pain, and no attack recurrence among the most important outcomes of acute treatment [1][2][3][4][5]. In line with these insights, as well as the consensus among migraine specialists that freedom from pain before use of rescue medication is clinically relevant and reflects patients' expectations [3,5,6], pain-free at 2 hours post-dose has replaced headache response as the primary measure of efficacy in acute migraine treatment studies [4].…”