1. Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European MigraineHeadache Alliance
- Author
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Sacco S., Lampl C., Maassen van den Brink A., Caponnetto V., Braschinsky M., Ducros A., Little P., Pozo-Rosich P., Reuter U., Ruiz de la Torre E., Sanchez Del Rio M., Sinclair A. J., Martelletti P., Katsarava Z., Cakciri G., Djamandi P., Grabova S., Halili G., Kruja J., Kuqo A., Naco D., Quka A., Stefanidhi L., Vyshka G., Zekja I., Bruera O., Gomez D., Guitian B., Roma J. C., Chen I. L., Bashirova S., Linkov M., Van Den Abbeele D., Vanderschueren G., Araujo R., Arruda R., Catharino A., Ciriaco J., Dalla Corte A., Dornas R., Felsenfeld B., Fonseca Taufner A., Fragoso Y., Hurtado R., Isoni Martins D., Londero R., Melo L., Mignoni K. S., Sgobbi De Souza P. V., Souza M. N., Osman S., Baltzer V., Pacheco Mosquera L. F., Dubroja I., Hucika Z., Lisak M., Lovrencic-Huzjan A., Lusic I., Mahovic Lakusic D., Mikulenka P., Rehulka P., Amin F. M., Antic S., Fakhril-Din Z., Moeller-Hansen J., Munksgaard S., Nan A. M., Pellesi L., Schytz H., Vides M., Braschinsky K., Krikmann U., Roos C., Cauchie A., Christian L., Guegan-Massardier E., Demarquay G., Gilles G., Mawet J., Kuhn E., Lanteri Minet M., Bustuchina Vlaicu M., Moisset X., Muresan M., Najjar-Ravan M., Giraud P., Simonin S., De Gaalon S., Chakhava G., Demuria M., Gegelashvili G., Kapanadze N., Antonakakis A., Gaul C., Forderreuther S., Huhn J. -I., Ibragimov S., Kamm K., Raffaelli B., Czaniera R., Ruscheweyh R., Gavanozi E., Karagiorgis G., Mavridism T., Ertsey C., Shubham D., Callista Tanowi A. D., Erdana Putra S., Hadi D. W., Kurnia L., Nasrul M., Albanese M., Antonaci F., Asioli G. M., Baschi R., Bentivegna E., Brunelli N., Caratozzolo S., Catarci T., Cherchi A., Corbelli I., Costa A., De Luca C., Doretti A., Favoni V., Ghiotto N., Giamberardino M. A., Giani L., Zanchin G., Govone F., Grillo G., Mampreso E., Negro A., Ornello R., Pasculli M., Pensato U., Prudenzano M. P. A., Quintana S., Rapisarda R., Romoli M., Russo A., Russo M., Spuntarelli V., Tiseo C., Torrente A., Vacca A., Vaula G., Vigano A., Vigneri S., Freimane A., Slosberga E., Zvaune L., Tan H. J., Fenech C., Cobilt-Catana R., De La Garza Neme Y., Martinez M., Proano Narvaez J. V., Rodriguez Herrera A., Vazquez D., Grosu O., Jakupi A., Kristoffersen E. S., Tronvik E., Winsvold B. S., Azhar M., Reyes Alvarez M. T., Vilchez Fernandez L., Dayrit G. D., Czapinska-Ciepiela E. K., Fila M., Gryglas-Dworak A., Couto M., Esperanca P., Ferreira A., Gil-Gouveia R., Goncalves A., Lopes M., Lourenco M., Machado J., Marinho M., Miranda M. A., Palavra F., Parreira E., Pavao Martins I., Pereira L., Pereira Monteiro J. M., Leahu P., Aloman S., Abramova E., Akhmadeeva L., Belopasova A., Bogdanova I., Chernyak M., Epifanova M., Fedorova E., Felbush A., Karpova M., Korobkova D., Korotkova D., Latysheva N., Makeeva T., Mikhalkina K., Osipova V., Roshchina O., Serga A., Serousova O. V., Sidorova Y., Skiba I., Skorobogatykh K., Vashchenko N., Apostolski S., Buder N., Kopitovic A., Mirjana J., Podgorac A., Rakic D., Simic S., Zarko M., Trajkovic J. Z., Beltran-Blasco I., Calabria Gallego M. D., Diaz Insa S., Ezpeleta D., Fernandez M., Garcia-Azorin D., Gonzalez-Garcia N., Guerrero A. L., Guillamon E., Herreros Rodriguez J., Layos-Romero A., Medrano V., Minguez-Olaondo A., Navarro Munoz S., Pare Curell M., Ruibal M., Sanchez Alvarez J. M., Santos S., Soler R., Viguera J., Zabalza R., Abdelrahman T., Abobaker Hamza S. B., Mustafa M. N., Edvinsson L., Gantenbein A., Maraffi I., Couturier E., Dirkx T., Hoebert M., Van Oosterhout W., Wim M., Zwartbol R., Bakir M., Demirel H., Erdemoglu A. K., Ertem D. H., Gonullu S., Ilgaz Aydinlar E., Inan L. E., Olmez B., Ozbenli T., Ozge A., Uluduz D., Uyar Cankay T., Yalinay Dikmen P., Saxena A. B., Bozhenko M., Bozhenko N., Bubnov R., Tsurkalenko O., Abu-Arafeh I., Idrovo L., Miller S., Nirmalananthan N., Sinclair A., Taleti E., Valori A., Whitehouse W., Zermansky A., Thura M., Institut Català de la Salut, [Sacco S, Caponnetto V] Neuroscience section – Department of Biotechnological and Applied Clinical Sciences and (Edificio Coppito 2), University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy. Regional Referral Headache Center of the Abruzzo Region, ASL Avezzano-Sulmona-L’Aquila, L’Aquila, Italy. [Lampl C] Department of Neurology, Headache Medical Centre Linz, Hospital Barmherzige Brüder, Centre of Integrative Medicine (ZiAM) Ordensklinikum Linz, Linz, Austria. [Maassen van den Brink A] Division of Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands. [Braschinsky M] Headache Clinic, Department of Neurology, Tartu University Clinics, Tartu, Estonia. [Ducros A] Headache Unit, Neurology Department, Montpellier University Hospital and Montpellier University, Montpellier, France. [Pozo-Rosich P] Unitat de Cefalea, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Grup d'Investigació en Cefalees i Dolors Neurològics, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Sacco, S., Lampl, C., Maassen van den Brink, A., Caponnetto, V., Braschinsky, M., Ducros, A., Little, P., Pozo-Rosich, P., Reuter, U., Ruiz de la Torre, E., Sanchez Del Rio, M., Sinclair, A. J., Martelletti, P., Katsarava, Z., Cakciri, G., Djamandi, P., Grabova, S., Halili, G., Kruja, J., Kuqo, A., Naco, D., Quka, A., Stefanidhi, L., Vyshka, G., Zekja, I., Bruera, O., Gomez, D., Guitian, B., Roma, J. C., Chen, I. L., Bashirova, S., Linkov, M., Van Den Abbeele, D., Vanderschueren, G., Araujo, R., Arruda, R., Catharino, A., Ciriaco, J., Dalla Corte, A., Dornas, R., Felsenfeld, B., Fonseca Taufner, A., Fragoso, Y., Hurtado, R., Isoni Martins, D., Londero, R., Melo, L., Mignoni, K. S., Sgobbi De Souza, P. V., Souza, M. N., Osman, S., Baltzer, V., Pacheco Mosquera, L. F., Dubroja, I., Hucika, Z., Lisak, M., Lovrencic-Huzjan, A., Lusic, I., Mahovic Lakusic, D., Mikulenka, P., Rehulka, P., Amin, F. M., Antic, S., Fakhril-Din, Z., Moeller-Hansen, J., Munksgaard, S., Nan, A. M., Pellesi, L., Schytz, H., Vides, M., Braschinsky, K., Krikmann, U., Roos, C., Cauchie, A., Christian, L., Guegan-Massardier, E., Demarquay, G., Gilles, G., Mawet, J., Kuhn, E., Lanteri Minet, M., Bustuchina Vlaicu, M., Moisset, X., Muresan, M., Najjar-Ravan, M., Giraud, P., Simonin, S., De Gaalon, S., Chakhava, G., Demuria, M., Gegelashvili, G., Kapanadze, N., Antonakakis, A., Gaul, C., Forderreuther, S., Huhn, J. -I., Ibragimov, S., Kamm, K., Raffaelli, B., Czaniera, R., Ruscheweyh, R., Gavanozi, E., Karagiorgis, G., Mavridism, T., Ertsey, C., Shubham, D., Callista Tanowi, A. D., Erdana Putra, S., Hadi, D. W., Kurnia, L., Nasrul, M., Albanese, M., Antonaci, F., Asioli, G. M., Baschi, R., Bentivegna, E., Brunelli, N., Caratozzolo, S., Catarci, T., Cherchi, A., Corbelli, I., Costa, A., De Luca, C., Doretti, A., Favoni, V., Ghiotto, N., Giamberardino, M. A., Giani, L., Zanchin, G., Govone, F., Grillo, G., Mampreso, E., Negro, A., Ornello, R., Pasculli, M., Pensato, U., Prudenzano, M. P. A., Quintana, S., Rapisarda, R., Romoli, M., Russo, A., Russo, M., Spuntarelli, V., Tiseo, C., Torrente, A., Vacca, A., Vaula, G., Vigano, A., Vigneri, S., Freimane, A., Slosberga, E., Zvaune, L., Tan, H. J., Fenech, C., Cobilt-Catana, R., De La Garza Neme, Y., Martinez, M., Proano Narvaez, J. V., Rodriguez Herrera, A., Vazquez, D., Grosu, O., Jakupi, A., Kristoffersen, E. S., Tronvik, E., Winsvold, B. S., Azhar, M., Reyes Alvarez, M. T., Vilchez Fernandez, L., Dayrit, G. D., Czapinska-Ciepiela, E. K., Fila, M., Gryglas-Dworak, A., Couto, M., Esperanca, P., Ferreira, A., Gil-Gouveia, R., Goncalves, A., Lopes, M., Lourenco, M., Machado, J., Marinho, M., Miranda, M. A., Palavra, F., Parreira, E., Pavao Martins, I., Pereira, L., Pereira Monteiro, J. M., Leahu, P., Aloman, S., Abramova, E., Akhmadeeva, L., Belopasova, A., Bogdanova, I., Chernyak, M., Epifanova, M., Fedorova, E., Felbush, A., Karpova, M., Korobkova, D., Korotkova, D., Latysheva, N., Makeeva, T., Mikhalkina, K., Osipova, V., Roshchina, O., Serga, A., Serousova, O. V., Sidorova, Y., Skiba, I., Skorobogatykh, K., Vashchenko, N., Apostolski, S., Buder, N., Kopitovic, A., Mirjana, J., Podgorac, A., Rakic, D., Simic, S., Zarko, M., Trajkovic, J. Z., Beltran-Blasco, I., Calabria Gallego, M. D., Diaz Insa, S., Ezpeleta, D., Fernandez, M., Garcia-Azorin, D., Gonzalez-Garcia, N., Guerrero, A. L., Guillamon, E., Herreros Rodriguez, J., Layos-Romero, A., Medrano, V., Minguez-Olaondo, A., Navarro Munoz, S., Pare Curell, M., Ruibal, M., Sanchez Alvarez, J. M., Santos, S., Soler, R., Viguera, J., Zabalza, R., Abdelrahman, T., Abobaker Hamza, S. B., Mustafa, M. N., Edvinsson, L., Gantenbein, A., Maraffi, I., Couturier, E., Dirkx, T., Hoebert, M., Van Oosterhout, W., Wim, M., Zwartbol, R., Bakir, M., Demirel, H., Erdemoglu, A. K., Ertem, D. H., Gonullu, S., Ilgaz Aydinlar, E., Inan, L. E., Olmez, B., Ozbenli, T., Ozge, A., Uluduz, D., Uyar Cankay, T., Yalinay Dikmen, P., Saxena, A. B., Bozhenko, M., Bozhenko, N., Bubnov, R., Tsurkalenko, O., Abu-Arafeh, I., Idrovo, L., Miller, S., Nirmalananthan, N., Sinclair, A., Taleti, E., Valori, A., Whitehouse, W., Zermansky, A., Thura, M., and Internal Medicine
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Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,medicine.medical_specialty ,Pediatrics ,Neurology ,Consensus ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos con cefaleas::cefaleas primarias::trastornos migrañosos [ENFERMEDADES] ,migraine ,migraine care ,refractory migraine ,resistant migraine ,consensus ,cross-sectional studies ,headache ,humans ,surveys and questionnaires ,migraine disorders ,Pain medicine ,Moderate confidence ,Migraine Disorders ,Medizin ,Consensu ,Migranya - Tractament ,Qüestionaris ,Refractory ,Surveys and Questionnaires ,medicine ,Surveys and Questionnaire ,Humans ,Clinical significance ,Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine Disorders [DISEASES] ,Otros calificadores::/terapia [Otros calificadores] ,Migraine ,Cross-Sectional Studie ,business.industry ,Headache ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,General Medicine ,Other subheadings::/therapy [Other subheadings] ,medicine.disease ,Refractory migraine ,Anesthesiology and Pain Medicine ,Cross-Sectional Studies ,Burden ,Medicine ,Neurology (clinical) ,Level of care ,business ,Resistant migraine ,Migraine care ,Human ,Research Article - Abstract
Background New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods We conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care. Results There were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care. Conclusions This report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities.
- Published
- 2021
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