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

Authors

  • Michel Lantéri-Minet MD,

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Hélène Massiou MD,

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Sophie Romatet MD,

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Adeline Barba MD,

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Christian Lucas MD,

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Bashar Allaf MD

    1. From Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France, (M. Lantéri-Minet); Private Neurologist, Antony, France (H. Massiou); Private Neurologist, Saint-Germain-en-Laye, France (S. Romatet); Almirall, Paris, France (A. Barba); Service de Neurologie, CHU de Nice, Lille, France (C. Lucas); Almirall, Paris, France (B. Allaf).
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  • Financial support: This work was supported by a grant from Almirall SAS.

  • Conflicts of Interests: M.L.M. has received personal compensation for activities (consulting, clinical research) with Allergan, Almirall SAS, Astra Zeneca Pharmaceuticals, Glaxo-Smith Kline Inc., Grunenthal, Eli Lilly & Company, Johnson & Johnson, Medtronic, Menarini, Merck, Pierre Fabre, Pfizer Inc., Sanofi-Aventis, UCB, Zambon. H.M. has been a consultant/scientific advisor in Advisory Boards, Clinical Trials, Investigator Initiated Trials and Speaker for: Allergan, Almirall Prodesfarma, AstraZeneca, GlaxoSmithKline, Janssen Cilag, Menarini, Merck, Novartis, Pfizer, Pierre Fabre, Schwarz Pharma. S.R. has perceived personal compensation for activities (consulting, clinical research) with Almirall, AstraZeneca, Eisa Merck, Serono. A.B. received consulting fees from Almirall SAS, France, for her participation in study Scientific Committee and involvement in study design, interpretation of data and manuscript preparation. C.L. has perceived personal compensation for activities (consulting, clinical research) with Allergan, Almirall SAS, Astra Zeneca Pharmaceuticals, Boehringer Ingelheim, Bouchara Recordati, Glaxo-Smith Kline Inc., Menarini, Merck, Pfizer Inc., Sanofi-Aventis. B.A. was a full-time employee of Almirall SAS, France, at the time of the study.

M. Lantéri-Minet, Département d'Evaluation et Traitement de la Douleur, C.H.U. de Nice, Hôpital Pasteur, 06602 Nicecedex, France.

Abstract

(Headache 2011;51:590-601)

Objective.— The objective of the nationwide EXPERT survey carried out in France in 2005 was to compare satisfaction with treatment with treatment effectiveness in migraine patients consulting general practitioners (GPs) for migraine, and to establish an instrument to easily evaluate the adequacy of acute treatment of migraine.

Background.— Many migraine patients feel satisfied with their current acute treatment of migraine whereas objective evaluation reveals poor treatment effectiveness.

Methods.— A total of 2108 GPs included 11,274 migraine patients. Satisfaction with treatment was evaluated using a 4-point verbal scale and a 10-cm visual analog scale (VAS). Treatment effectiveness was assessed by the 4-item questionnaire designed by the French Medico-Economic Evaluation Service (ANAES) and the French Society for the Study of Migraine Headache (SFEMC).

Results.— In total, 5224 patients (49.8%) stated that they were satisfied with their treatment. Mean VAS score was 5.1. Only 17% of patients (1789/10,539) gave positive responses at the 4 questions of the ANAES/SFEMC questionnaire. VAS score was high for patients satisfied with their treatment and with good treatment effectiveness. Two VAS thresholds were determined using receiver operating characteristic curves that allowed easy identification, with high sensitivity and specificity, of patients satisfied/dissatisfied with their current treatment and with good/poor treatment effectiveness. Based on EXPERT data, this instrument showed that only 16% of patients using triptans (597/3719) were dissatisfied and reported poor treatment effectiveness, whereas treatment was inadequate for 63% of those using aspirin or nonsteroidal anti-inflammatory drugs (1882/2992), 74% of those using paracetamol or other analgesics (2229/2998), and 53% of those using ergotamine (253/474).

Conclusions.— 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.

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