Introduction: Many patients with migraine do not consult a physician, or do not achieve adequate relief after consulting a physician because of undertreatment. The objective of the Migraine and Zomig1. Evaluation study was to provide insights into the management of migraine in the general population.
Methods: In phase I, 5553 members of the general public in the UK, France, Germany, Italy, and the US were interviewed by telephone and classified according to International Headache Society criteria. The Migraine Disability Assessment Scale (MIDAS) questionnaire was used to assess the impact of migraine on work, home and social lives. In phase II, 516 patients with clinically diagnosed migraine were interviewed to assess the impact of migraine on daily life, attitudes towards migraine, perceptions of current treatments and aspirations for future treatments.
Results: In phase I, the average prevalence of migraine over the five countries was 9%. Migraine posed a significant burden in terms of the impact on patients’ daily lives, and attack severity and frequency. However, medical consultation rates were low; reasons for this included patients not recognising that they had migraine or having low expectations about treatment benefits. On average, only 10% of patients who had consulted a physician had been prescribed a triptan. Only 22% of participants in phase II thought that migraine did not markedly affect their lives. In each of the five countries, ≥ 50% of patients required bed rest to manage migraine attacks, demonstrating the impact of migraine-related disability on patients’ lives. Assessment of MIDAS scores confirmed the debilitating effect of migraine; > 50% of respondents had a MIDAS grade of III or IV, indicating moderate or severe disability. Less than one-third of patients reported that their current medication was consistently effective and only 36% were ‘very satisfied’ with their current therapy. High efficacy and rapid pain relief were rated as the most important attributes of migraine medications. When asked which formulation they would like to see more of, most patients chose a tablet that dissolves in the mouth without the need to take liquids.
Conclusions: These results show that migraine patients worldwide are still not receiving adequate treatment and there remains a significant unmet need in migraine care. The challenge for the future is to diagnose migraine early and offer patients effective migraine-specific therapies. Physicians particularly need to reach patients who do not realise they have migraine and those who have lapsed from care.
Migraine Migraine Attack Migraine Patient Zolmitriptan International Headache Society
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
This study was supported by AstraZeneca. Dr J.L. Brandes serves as a consultant and is on a speaker bureau for AstraZeneca.
Terwindt GM, Ferrari MD, Tijhuis M, et al. The impact of migraine on quality of life in the general population: the GEM study. Neurology 2000; 55: 624–9PubMedCrossRefGoogle Scholar
Dowson A, Jagger S. The UK migraine patient survey: quality of life and treatment. Curr Med Res Opin 1999; 15: 241–53PubMedCrossRefGoogle Scholar
Lipton RB, Hamelsky SW, Kolodner KB, et al. Migraine, quality of life, and depression. A population-based case-control study. Neurology 2000; 55: 629–35PubMedCrossRefGoogle Scholar
Stang PE, Osterhaus J. Impact of migraine in the United States: data from the National Health Interview Survey. Headache 1993; 33: 29–35PubMedCrossRefGoogle Scholar
Lipton RB, Stewart WF, Simon D. Medical consultation for migraine: results from the American Migraine Study. Headache 1998; 38: 87–96PubMedCrossRefGoogle Scholar
Lipton RB, Stewart WF, Celentano D, et al. Underdiagnosed migraine headaches: a comparison of symptom-based and reported physician diagnosis. Arch Intern Med 1992; 152: 1273–8PubMedCrossRefGoogle Scholar
Richard A, Massiou H, Herrmann MA. Frequency and profile of migraine patients seen by general practitioners. Semin Hop Paris 1999; 75: 440–6Google Scholar
Lipton RB, Stewart WF. Acute migraine therapy: do doctors understand what patients with migraine want from therapy. Headache 1999; 39Suppl. 2: 20–6CrossRefGoogle Scholar
Rapoport AM, Ramadan NM, Adelman JU, et al. Optimizing the dose of zolmitriptan (Zomig, 311C90) for the acute treatment of migraine. A multicenter, double-blind, placebo-controlled, dose range-finding study. The 017 Clinical Trial Study Group. Neurology 1997; 49: 1210–8PubMedCrossRefGoogle Scholar
Solomon GD, Cady RK, Klapper JA, et al. Clinical efficacy and tolerability of 2.5 mg zolmitriptan for the acute treatment of migraine. The 042 Clinical Trial Study Group. Neurology 1997; 49: 1219–25PubMedCrossRefGoogle Scholar
Schoenen J, Sawyer J. Zolmitriptan (Zomig™, 311C90), a novel dual central and peripheral 5HT1B/1D agonist: an overview of efficacy. Cephalalgia 1997; 17Suppl. 18: 28–40PubMedGoogle Scholar
Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1998; 8Suppl. 7: 1–96Google Scholar
Göbel H. Paper-pencil tests for retrospective and prospective evaluation of primary headaches on the basis of the IHS criteria. Headache 1994; 34: 564–8PubMedCrossRefGoogle Scholar
Stewart WF, Lipton RB, Kolodner K, et al. Reliability of the migraine disability assessment score in a population-based sample of headache sufferers. Cephalalgia 1999; 19: 107–14PubMedCrossRefGoogle Scholar
Stewart WF, Lipton RB, Celentano DD, et al. Prevalence of migraine headache in the United States. JAMA 1992; 267: 64–9PubMedCrossRefGoogle Scholar
Pryse-Phillips W, Findlay H, Tugwell P, et al. A Canadian population survey on the clinical, epidemiologic and societal impact of migraine and tension-type headache. Can J Neurol Sci 1992; 19: 333–9PubMedGoogle Scholar
Tfelt-Hansen P, De Vries P, Saxena PR, et al. Triptans in migraine. A comparative review of pharmacology, pharmacokinetics and efficacy. Drugs 2000; 60: 1259–87PubMedCrossRefGoogle Scholar
Lipton RB, Stewart WF, Stone AM, et al. Stratified care vs step care strategies for migraine. The Disability in Strategies of Care (DISC) study: a randomized trial. JAMA 2000; 284: 2599–605PubMedCrossRefGoogle Scholar