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Migraine - Patient focus

4 MIN

Latest results from the OVERCOME survey—the other side to acute migraine treatment optimization

Since inadequate acute migraine treatment is associated with an increased risk of new-onset chronic migraine,1 providing fast and effective treatment is central to daily migraine clinical care. Tools for treatment optimization, such as the Migraine Treatment Optimization Questionnaire (mTOQ-4), aid clinicians to provide efficient treatment focusing on pain resolution and restoring function.2 However, disability and health-related quality of life (HRQoL) should also be considered when optimizing care in migraine. At the recent 14th Congress of the European Headache Federation (EHF) held virtually on 29 June – 2 July 2020, Professor Dawn Buse (Albert Einstein College of Medicine, New York, USA) provided an overview of the latest results from the OVERCOME study in her presentation “Acute Treatment Optimization Influences Disability and Quality of Life in Migraine: Results of the ObserVational Survey of the Epidemiology, treatment and Care Of Migraine (OVERCOME) Study.”

Optimizing acute treatment may improve quality of life, well-being and function during an attack and on a more global and broader scale.
Dawn Buse

OVERCOME study investigates treatment optimization and burden of migraine

Prof. Buse started by explaining that the OVERCOME study is a web-based survey for migraineurs. Participants could take part in the survey if they met the 3rd edition of the International Classification of Headache Disorders (ICHD-3) criteria for migraine and had completed measures of 1) acute treatment optimization (mTOQ-4), 2) disability (Migraine Disability Assessment Scale [MIDAS]), and 3) HRQoL (Migraine-Specific Quality of Life Questionnaire, Role Function – Restrictive subscale [MSQ-RFR]).2 Respondents were also asked to assess the impact of a migraine attack. The relationship between mTOQ, MIDAS and MSQ-RFR across categories based on migraine headache days (MHDs) per month (0–3, 4–7, 8–14, ≥15 MHDs) was subsequently analyzed.2 Prof. Buse proceeded to explain their findings.

Treatment optimization lowers disability levels, increases HRQoL and reduces migraine attack impact

The results obtained from cohort 1 (20,041 people) of the OVERCOME study were presented by Prof. Buse. More than half (57.3%) of respondents experienced 0–3 monthly headache days, 51.1% of respondents had poor or very poor treatment optimization according to mTOQ-4, and 43.1% had moderate or severe disability according to MIDAS, noted Prof. Buse. She explained that respondents with very poor acute treatment optimization obtained the worst disability scores. Indeed, Prof. Buse indicated, MIDAS total scores showed a negative association with mTOQ-4 scores. She proceeded with HRQoL measures, where MSQ-RFR scores showed a positive association with mTOQ-4 scores. Prof. Buse explained that high MSQ-RFR scores indicate better quality of life, therefore indicating that improved treatment optimization is also associated with better quality of life. Furthermore, respondents with very poor treatment optimization were more impacted by a migraine attack, noted Prof. Buse. She concluded by adding that the associations found held true across all individual ‘migraine headache days per month’ categories as well as in the overall population.

Incorporating instruments for acute treatment optimization is encouraged in daily practice

These initial results from the OVERCOME study illustrate the importance of acute treatment optimization in migraine. People with migraine who engage in high treatment optimization generally report lower levels of migraine-associated disability, lower impact of migraine attacks and higher quality of life compared to those with poor treatment optimization. Prof. Buse ended her presentation with a call to action for clinicians to incorporate instruments that measure acute treatment optimization in daily practice.

References

  1. Lipton RB, Fanning KM, Serrano D, et al. Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine. Neurology 2015;84:688–695.

  2. Buse D, Kovacik AJ, Nicholson RA et al. Acute Treatment Optimization Influences Disability and Quality of Life in Migraine: Results of the ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) Study. Neurology 2020;94(S15):4154.

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