Patients’ Values and Preferences Regarding Pharmacologic Treatments for the Prevention of Episodic Migraine Headache: A Systematic Review for the American College of Physicians
Abstract
BACKGROUND
Decision making regarding pharmacologic treatments for the prevention of episodic migraine may depend on the importance that patients place on outcomes and specific treatment preferences.
PURPOSE
To assess patients' values and preferences regarding pharmacologic treatments for the prevention of episodic migraine.
DATA SOURCES
MEDLINE and CINAHL from inception to April 2024.
STUDY SELECTION
Quantitative studies reporting on values and preferences regarding pharmacologic treatments for the prevention of migraine in adults were eligible.
DATA EXTRACTION
We extracted data on study design, participants, and findings and assessed risk of bias using a tool developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.
DATA SYNTHESIS
We included 6 studies (5 discrete choice experiments and 1 survey) comprising a total of 2307 participants and assessing the importance of a total of 32 attributes. Risk of bias was moderate in 3 and low in 3 studies; all but 1 were industry spon sored. Migraine severity, frequency, and duration were found to be the most important among several outcomes including acute medication need and side effects (low certainty). Other outcomes of importance were migraine attack on day 1 postdosing (moderate certainty) and duration of daily activity limitations (high certainty). Patients preferred oral tablets to injections and infusions (moderate certainty).
LIMITATIONS
Importance of attributes relative to each…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,307 participants or records.
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