• Exploring Migraine Impact May Yield More Accurate Treatment

    Information provided by Eli Lilly

    Eli Lilly

    Despite migraine being one of the most common diseases and impacting more than 30 million adults in the U.S.,1 many adults still push through the pain rather than speaking openly with their health care professional (HCP) about their symptoms and the impact migraine has on their day-to-day life.2 In fact, almost half of American adults with migraine hesitate to seek care,2 and only 30 percent are taking a recommended prescription medication to treat migraine.3,4

    Facilitating meaningful conversations between people with migraine and HCPs could be key to diagnosing and treating migraine. A simple algorithm can help guide these discussions to uncover the impact of migraine:

    • THINK: Ask patients whether headaches limit their activities and if they experience additional symptoms, such as nausea and/or sensitivity to light. If the answer is “yes” to at least two of these symptoms, it is highly likely they have migraine.5

    • TALK: Discuss migraine frequency and impact on daily activities during and between attacks to help inform treatment decisions.

    • TREAT: Following a diagnosis of migraine, it is important to treat it early and effectively for best results.6-8 People with migraine who experience one or more attacks a month should be offered a recommended* acute treatment, while for those who experience four or more days with migraine per month, both acute treatment and preventive treatment are recommended.*6,9,10

    Exploring Migraine Treatment Options — Acute and Preventive

    Acute medications are recommended when a migraine strikes to reduce pain, associated symptoms, and disability.6 The goals and considerations of acute treatment are freedom from pain and associated symptoms, especially the most bothersome symptom, within 2 hours and without recurrence; restored ability to function; and minimal side effects.6,10 Classes of medications recommended by the American Headache Society (AHS) for acute treatment of migraine include antiemetics, ditans, ergotamine and other forms of dihydroergotamine, ergotamine derivatives, calcitonin gene-related peptide (CGRP) oral antagonists (gepants), isometheptene-containing compounds, NSAIDs, and triptans, as well as combination medications.6

    The goals of migraine prevention are to reduce attack frequency, severity, duration, and disability; to reduce headache-related distress and psychological symptoms; and to improve function, quality of life, and responsiveness to acute treatment.6 Classes of medications recommended by AHS for the preventive treatment of migraine include antidepressants, antiepileptics, beta blockers, CGRP antagonists including CGRP monoclonal antibodies and gepants, onabotulinumtoxinA, and triptans.6

    The impact of migraine extends beyond the pain. People with the disease may face reduced energy and tiredness, difficulties concentrating and performing at work, and interference with relationships.11,12 It is crucial to have open and honest conversations to determine if a migraine diagnosis is indicated and explore proper treatment so patients may achieve relief from attacks and live life without worrying about when the next migraine may strike.

    For more information and resources to support meaningful migraine conversations, please visit thinkmigraine.com/hcp.

    *Recommended medications refer to those with established/probable efficacy as identified by the American Academy of Neurology/AHS guidelines and the AHS position statement regarding new migraine treatments.6,9

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    1. Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache. 2015;55 Suppl 2:103-26
    2. Shapiro R. et al. Reasons for Hesitating to Consult for Migraine Care: Results of the OVERCOME (US) Study. Poster presented at: 63rd Virtual Annual Scientific Meeting of the American Headache Society (AHS), 2021; June 3, 2021.
    3. Nicholson RA, Hutchinson S, Vargas B, Buse DC, Reed ML, et al. Seeking care, diagnosis, and acute prescription for migraine among those with headache-related disability: results of the OVERCOME study. Headache. 2020;60(S1):132-133.
    4. Ashina S, Nicholson RA, Buse DC, Reed ML, Vargas B, et al. Identifying barriers to care-seeking, diagnosis, and preventive medication among those with migraine: results of the OVERCOME study. Headache. 2020;60(S1):127-128.
    5. Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine™ validation study. Neurology. 2003;61(3);375-382.
    6. Ailani J, Burch RC, Robbins MS. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039.
    7. Buse DC, Greisman JD, Baigi K, Lipton RB. Migraine progression: a systematic review. Headache. 2019;59(3):306-338.
    8. Buse DC, Kovacik AJ, Nicholson RA, Doty EG, Araujo AB, 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(Suppl 15): 4154.
    9. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults. Neurology. 2012;78(17):1337-1345.
    10. Dabertin T. National Headache Foundation Position Statement on the Treatment of Migraine and Access to Care. 2022. https://headaches.org/national-headache-foundation-position-statement-on-the-treatment-of-migraine
    11. Lipton RB, Bigal ME, Kolodner K, Stewart WF, Liberman JN, Steiner TJ. The family impact of migraine: population-based studies in the USA and UK. Cephalalgia. 2003;23(6):429-440.
    12. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF; AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343-349.
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