Acute treatment optimization for migraine: results of the American migraine prevalence and prevention (AMPP) study: [Doc 537]

Lipton et al. The Journal of Headache and Pain 2013, 14(Suppl 1):P201 http://www.thejournalofheadacheandpain.com/content/14/S1/P201

POSTER PRESENTATION Open Access

Acute treatment optimization for migraine: results of the American migraine prevalence and prevention (AMPP) study

RB Lipton1*, AN Manack2, D Serrano3, DC Buse4

From The European Headache and Migraine Trust International Congress London, UK. 20-23 September 2012

Objectives

To assess and compare acute treatment optimization as measured by the Migraine Treatment Optimization Questionnaire (M-TOQ) within a population-based sample of persons with migraine.

Methods

AMPP is a longitudinal, US-population-based study for which questionnaires were mailed to 24,000 severe headache sufferers and followed annually. Respondents with ICHD-2 migraine were stratified as either CM (>15 headache-days/month) or EM (<15 headache-days/month). Acute-treatment optimization was measured with MTOQ, a valid/reliable patient-report tool assessing 5 domains: functioning, rapid relief, relief consistency, recurrence risk, tolerability over preceding 4 weeks. Respondents rated statements in each area as either occur-ring: never, rarely, < or > half the time. An item response theory (IRT) model used to define scaled treatment optimization scores as function of M-TOQ item set: lower scores=less/problematic optimization; higher scores=greater optimization. The model was expanded to incorporate persons with CM/EM on scaled scores and explored demographic adjustments for age and gender.

Results

8612 persons met criteria for migraine (CM=539;

EM=8073) and completed M-TOQ. IRT model parameters indicated excellent M-TOQ psychometric properties. Scaled treatment optimization scores were significantly lower for persons with CM (3.25) vs EM(4.01, b=-0.757; p<.0001), corresponding to a 0.5 standard

deviation (SD) difference between CM and EM. After adjustment, mean difference on scaled-optimization score remained significantly lower (worse) for CM (b=-0.751; p<.0001).

Discussion

Treatment regimens were less well-optimized and more lacking in domains measured by M-TOQ (ie, functioning, rapid relief, consistency of relief, risk of recurrence and tolerability) among persons with CM vs EM. Funding: The AMPP study was funded through a research grant to the NHF from Ortho-McNeil Neurologics. Additional analyses were supported by Allergan, Inc.

Author details

1Department of Neurology, Montefiore Medical Center, Bronx, New York, USA. 2Allergan, Inc., Irvine, California, USA. 3Vedanta Research, Chapel Hill, North Carolina, UK. 4Department of Neurology, Montefiore Medical Center, Bronx, New York, UK.

Published: 21 February 2013

doi:10.1186/1129-2377-14-S1-P201Cite this article as: Lipton et al.: Acute treatment optimization for migraine: results of the American migraine prevalence and prevention (AMPP) study. The Journal of Headache and Pain 2013 14(Suppl 1):P201.

1Department of Neurology, Montefiore Medical Center, Bronx, New York, USAFull list of author information is available at the end of the article

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