000078136 001__ 78136
000078136 005__ 20200716101436.0
000078136 0247_ $$2doi$$a10.1186/s10194-019-0971-6
000078136 0248_ $$2sideral$$a110900
000078136 037__ $$aART-2019-110900
000078136 041__ $$aeng
000078136 100__ $$aGarcía-Azorin, D.
000078136 245__ $$aReal world preventative drug management of migraine among Spanish neurologists
000078136 260__ $$c2019
000078136 5060_ $$aAccess copy available to the general public$$fUnrestricted
000078136 5203_ $$aBACKGROUND: Many different preventatives have showed efficacy in the treatment of migraine. National guidelines differ in their recommendations and patients' characteristics are usually taken into account in their selection. In Spain, real life use of preventive therapies seems to be heterogeneous. We aimed to evaluate differences in clinical practice and adherence to national guidelines among Spanish neurologists.
METHODS: Observational descriptive study. A survey was conducted among neurologists ascribed to the Spanish Society of Neurology. Participants were differentiated in accordance with their dedication to headache disorders. We analysed socio-demographic parameters and evaluated 43 questions considering migraine management as well as therapeutic choices regarding migraine sub-types and finally, neurologists' personal perception.
RESULTS: One hundred fifty-five neurologists participated from 17 different regions, 43.4% of them female and 53.3% under 40¿years of age. 34.9% confirmed headache disorders as their main interest. The first choice for preventive therapy in chronic migraine among participants was topiramate (57%) followed by amytriptiline (17.9%) and beta-blockers (14.6%). However in episodic migraine, the preferred options were beta-blockers (47.7%), topiramate (21.5%) and amytriptiline (13.4%). Regarding perceived efficacy, topiramate was considered the best option in chronic migraine (42.7%) followed by onabotulinumtoxinA (25.5%) and amitryptiline (22.4%). Where episodic migraine was concerned, surveyed neurologists perceived topiramate (43.7%) and beta-blockers (30.3%) as the best options. When we evaluated the duration of treatment use with a view to adequate therapeutic response, 43.5% of neurologists preferred 3¿months duration and 39.5% were in favour of 6¿months duration in episodic migraine. However, considering the preferred duration of treatment use in chronic migraine, 20.4% recommended 3¿months, 42.1% preferred 6¿months and 12.5% and 22.4% opted for 9 and 12¿months respectively. When considering onabotulinumtoxinA therapy, the number of prior therapeutic failures was zero in 7.2% of neurologists, one in 5.9%, two in 44.1%, three in 30.9% and four or more in 11.9%. Following an initial treatment failure with onabotulinumtoxinA, 49% of subjects decided against a second treatment. The number of OnabotA procedures before considering it as ineffective was two in 18.9% of neurologists, three in 70.8% and four in 10.4%.
CONCLUSIONS: The initial management of migraine among Spanish Neurologists is in line with most guidelines, where first choice preventative drugs are concerned. The Management of episodic migraine differed from chronic migraine, both in terms of neurologist preference and in their perceived efficacy.
000078136 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000078136 590__ $$a4.797$$b2019
000078136 592__ $$a1.339$$b2019
000078136 591__ $$aNEUROSCIENCES$$b56 / 271 = 0.207$$c2019$$dQ1$$eT1
000078136 593__ $$aAnesthesiology and Pain Medicine$$c2019$$dQ1
000078136 591__ $$aCLINICAL NEUROLOGY$$b33 / 204 = 0.162$$c2019$$dQ1$$eT1
000078136 593__ $$aNeurology (clinical)$$c2019$$dQ1
000078136 593__ $$aMedicine (miscellaneous)$$c2019$$dQ1
000078136 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000078136 700__ $$0(orcid)0000-0001-5139-6031$$aSantos-Lasaosa, S.$$uUniversidad de Zaragoza
000078136 700__ $$aGago-Veiga, A.B.
000078136 700__ $$aViguera Romero, J.
000078136 700__ $$aGuerrero-Peral, A.L.
000078136 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000078136 773__ $$g20, 1 (2019), 19$$pJ. headache pain$$tThe Journal of headache and pain$$x1129-2369
000078136 8564_ $$s308364$$uhttps://zaguan.unizar.es/record/78136/files/texto_completo.pdf$$yVersión publicada
000078136 8564_ $$s91318$$uhttps://zaguan.unizar.es/record/78136/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000078136 909CO $$ooai:zaguan.unizar.es:78136$$particulos$$pdriver
000078136 951__ $$a2020-07-16-08:55:29
000078136 980__ $$aARTICLE