Why Offer Preventive Treatment?

Preventive treatment is recommended to reduce the frequency, severity and duration of migraine attacks.1

 

Prevention should be considered if1:

 

  • Migraine attacks are causing frequent disability
  • The patient is at risk of medication overuse headache from acute medications
  • Standard analgesics or triptans are contraindicated or ineffective
  • The patient has an uncommon type of migraine

 

Goals for preventive migraine treatment


Preventive migraine treatments aim to:

 

1. Decrease attack frequency (by at least 50% within 3 months) and duration2,3
2. Improve responsiveness to acute therapy4
3. Improve function and decrease disability2
4. Prevent medication overuse headache and chronic daily headache5



Preventive treatment is particularly important for people whose migraine has a substantial impact on their daily lives. 

 

45% of patients receiving preventive therapy experience a reduction in monthly frequency of attacks by 50% or more7

 

34% of people who suffer from migraine attacks could benefit from preventive treatment8

 

Fewer than 14% of patients appropriate for preventive treatment currently use these treatments8

 

Find preventive treatment options 

 

Importance of continual assessment

 

The preventive treatment options currently available have made an impact on the lives of people with migraine, for example reducing migraine diagnosis-related office and outpatient visits in 50% of patients and decreasing emergency department visits by 80% in a US study.9



However, challenges remain. In fact, another US study indicated that fewer than 20% of people with migraine continued use of common oral preventive medications after 1 year.10 Therefore, it is critically important to continually assess your patients' progress against their personalized goals and consider whether they need any changes in their migraine management or further information and education relevant to their current lifestyle and health status.

 

Why is treatment review  important?

 

References


1. National Institute for Health and Care Excellence. Clinical knowledge summaries: migraine updated February 2018. Available at: https://cks.nice.org.uk/migraine#!scenarioclarification:3 (accessed August 2018)

2. Antonaci F et al. Recent advances in migraine therapy. Springerplus 2016; 5: 637

3. Evers S et al. EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force. Eur J Neurol 2009; 16(9): 968–981

4. Antonaci F et al. A review of current European treatment guidelines for migraine. J Headache Pain 2010; 11: 13–19

5. British Association for the Study of Headache. Guidelines for all healthcare professionals in the diagnosis and management of Migraine. 3rd edition. September 2010

6. Lipton RB et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007; 68(5): 343–349

7. D’Amico D, Tepper SJ. Prophylaxis of migraine: general principles and patient acceptance. Neuropsychiatr Dis Treat 2008; 4(6): 115–116

8. American Academy of Neurology. Prescription drug treatment for migraine prevention in adults 2013. Available at: https://www.aan.com/Guidelines/Home/GetGuidelineContent/544 (accessed August 2018)

9. Silberstein SD. Preventive migraine treatment. Continuum 2015; 21: 973–989

10. Hepp Z et al. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia 2015; 35(6): 478–488

 

Why is treatment review important?

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