Tags

Type your tag names separated by a space and hit enter

Acute treatment optimization in episodic and chronic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study.

Abstract

BACKGROUND

The migraine Treatment Optimization Questionnaire (mTOQ) was developed to assess response to acute treatment in persons with migraine. The original validated form used yes or no response options.

OBJECTIVES

This study aims to (1) assess the psychometric properties of a 6-item version of the mTOQ (mTOQ-6) using ordinal response options; (2) compare treatment optimization using the revised mTOQ-6 for both episodic and chronic migraine (EM and CM, respectively); (3) identify demographic, headache, and treatment features associated with treatment optimization.

METHODS

The American Migraine Prevalence and Prevention (AMPP) Study is a longitudinal, US population-based study. Annual questionnaires were mailed to a sample of 24,000 severe headache sufferers identified by screening a panel constructed to be representative of the US population. The current study included respondents to the 2006 AMPP Study survey who met modified International Classification of Headache Disorders-3 beta criteria for migraine; persons with CM (≥15 HA days/month) or EM (<15 HA days/month) were included. Acute treatment optimization was measured with the mTOQ-6. A single factor latent variable model was used to assess item characteristics. This model was expanded through structural equation models (SEM) to incorporate a contrast between persons with CM and EM on the scaled treatment optimization scores. We estimated both an unadjusted SEM and a SEM adjusted for demographic features, headache characteristics, and acute treatment.

RESULTS

Migraine criteria were met by 8612 persons (539 for CM and 8073 for EM) who completed the mTOQ-6 as part of the 2006 AMPP Study survey. When compared, those with CM exhibited worse treatment optimization across all domains of the mTOQ-6. For example, 35.1% of CM and 44.6% of EM respondents reported being pain free at 2 hours "half the time or more" with their usual migraine medication. Latent variable model parameters indicated excellent psychometric properties of the mTOQ-6. Scaled treatment optimization scores obtained from the unadjusted SEM were significantly lower (indicating worse treatment optimization) for persons with CM (3.25) compared to persons with EM (4.01), b = -0.76, P < .0001; scores remained significantly lower for CM after adjustment with a wide array of demographic and disease severity covariates. Poor treatment optimization was associated with cutaneous allodynia, major depression, and the use of nonsteroidal anti-inflammatory drugs. Better treatment optimization was associated with the use of triptans and preventive medications.

CONCLUSION

Estimates of the latent variable scores for the mTOQ-6 revealed persistent low levels of treatment optimization for both EM and CM, though treatment optimization is worse for CM.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Endpoint Outcomes, Boston, MA, USA; Albert Einstein College of Medicine, Bronx, NY, USA.

    , , ,

    Source

    Headache 55:4 2015 Apr pg 502-18

    MeSH

    Chronic Disease
    Female
    Humans
    Longitudinal Studies
    Male
    Migraine Disorders
    Population Surveillance
    Surveys and Questionnaires
    Treatment Outcome
    Tryptamines
    United States

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    25881676

    Citation

    Serrano, Daniel, et al. "Acute Treatment Optimization in Episodic and Chronic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study." Headache, vol. 55, no. 4, 2015, pp. 502-18.
    Serrano D, Buse DC, Manack Adams A, et al. Acute treatment optimization in episodic and chronic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2015;55(4):502-18.
    Serrano, D., Buse, D. C., Manack Adams, A., Reed, M. L., & Lipton, R. B. (2015). Acute treatment optimization in episodic and chronic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 55(4), pp. 502-18. doi:10.1111/head.12553.
    Serrano D, et al. Acute Treatment Optimization in Episodic and Chronic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2015;55(4):502-18. PubMed PMID: 25881676.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Acute treatment optimization in episodic and chronic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study. AU - Serrano,Daniel, AU - Buse,Dawn C, AU - Manack Adams,Aubrey, AU - Reed,Michael L, AU - Lipton,Richard B, PY - 2015/02/01/accepted PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/3/15/medline KW - acute treatment KW - chronic migraine KW - episodic migraine KW - migraine KW - outcome KW - treatment optimization SP - 502 EP - 18 JF - Headache JO - Headache VL - 55 IS - 4 N2 - BACKGROUND: The migraine Treatment Optimization Questionnaire (mTOQ) was developed to assess response to acute treatment in persons with migraine. The original validated form used yes or no response options. OBJECTIVES: This study aims to (1) assess the psychometric properties of a 6-item version of the mTOQ (mTOQ-6) using ordinal response options; (2) compare treatment optimization using the revised mTOQ-6 for both episodic and chronic migraine (EM and CM, respectively); (3) identify demographic, headache, and treatment features associated with treatment optimization. METHODS: The American Migraine Prevalence and Prevention (AMPP) Study is a longitudinal, US population-based study. Annual questionnaires were mailed to a sample of 24,000 severe headache sufferers identified by screening a panel constructed to be representative of the US population. The current study included respondents to the 2006 AMPP Study survey who met modified International Classification of Headache Disorders-3 beta criteria for migraine; persons with CM (≥15 HA days/month) or EM (<15 HA days/month) were included. Acute treatment optimization was measured with the mTOQ-6. A single factor latent variable model was used to assess item characteristics. This model was expanded through structural equation models (SEM) to incorporate a contrast between persons with CM and EM on the scaled treatment optimization scores. We estimated both an unadjusted SEM and a SEM adjusted for demographic features, headache characteristics, and acute treatment. RESULTS: Migraine criteria were met by 8612 persons (539 for CM and 8073 for EM) who completed the mTOQ-6 as part of the 2006 AMPP Study survey. When compared, those with CM exhibited worse treatment optimization across all domains of the mTOQ-6. For example, 35.1% of CM and 44.6% of EM respondents reported being pain free at 2 hours "half the time or more" with their usual migraine medication. Latent variable model parameters indicated excellent psychometric properties of the mTOQ-6. Scaled treatment optimization scores obtained from the unadjusted SEM were significantly lower (indicating worse treatment optimization) for persons with CM (3.25) compared to persons with EM (4.01), b = -0.76, P < .0001; scores remained significantly lower for CM after adjustment with a wide array of demographic and disease severity covariates. Poor treatment optimization was associated with cutaneous allodynia, major depression, and the use of nonsteroidal anti-inflammatory drugs. Better treatment optimization was associated with the use of triptans and preventive medications. CONCLUSION: Estimates of the latent variable scores for the mTOQ-6 revealed persistent low levels of treatment optimization for both EM and CM, though treatment optimization is worse for CM. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/25881676/Acute_treatment_optimization_in_episodic_and_chronic_migraine:_results_of_the_American_Migraine_Prevalence_and_Prevention__AMPP__Study_ L2 - https://doi.org/10.1111/head.12553 DB - PRIME DP - Unbound Medicine ER -