Clinical determinants of migraine preventive treatment: Contribution of SMILE, an observational survey of primary care migraine management in France

Author:

Valade D1,Lantéri-Minet M2,Radat F3,Mekies C4,Lucas C5,Vivès E6,Joubert JM7,Géraud G8

Affiliation:

1. Lariboisière Hospital, France.

2. Pasteur University Hospital, France.

3. Pellegrin University Hospital, France.

4. Private neurology practice, France.

5. Salengro Hospital, France.

6. General practice, France.

7. Schwarz Pharma, France.

8. Rangueil Hospital, France.

Abstract

Methods: SMILE was an observational study carried out in France among office-based general practitioners (GPs) and neurologists from November 2005 to July 2006 to assess the determinants of prescription of migraine preventive therapy in primary care medicine. A total of 1467 GPs and 83 neurologists were included, treating 5417 and 248 migraine sufferers, respectively. Results: The main factors leading physicians to deem a patient eligible for preventive treatment were perceived medication overuse and frequency of headaches, and secondarily, severity of headaches and functional impact. On the other hand, patient satisfaction with the acute treatment of attacks and triptan use, and secondarily, a long migraine history were found to influence patient eligibility negatively. Discussion/conclusion: Noticeably, psychiatric disorders (anxiety, stress) did not appear, aside from somatic factors, among the determinants that significantly influence physicians' judgment about the option of establishing a preventive treatment. However, they are important features of migraine condition and should be listed among the factors guiding choices about migraine preventive therapy.

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

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