title: An instrument to assess patient perceptions of satisfaction with acute migraine treatment (EXPERT Study).
abstract: OBJECTIVE
  The objective of the nationwide EXPERT survey carried out in France in 2005 was to compare satisfaction with treatment with treatment effectiveness in migraine patients consulting general practitioners (GPs) for migraine, and to establish an instrument to easily evaluate the adequacy of acute treatment of migraine.
  
  
  BACKGROUND
  Many migraine patients feel satisfied with their current acute treatment of migraine whereas objective evaluation reveals poor treatment effectiveness.
  
  
  METHODS
  A total of 2108 GPs included 11,274 migraine patients. Satisfaction with treatment was evaluated using a 4-point verbal scale and a 10-cm visual analog scale (VAS). Treatment effectiveness was assessed by the 4-item questionnaire designed by the French Medico-Economic Evaluation Service (ANAES) and the French Society for the Study of Migraine Headache (SFEMC).
  
  
  RESULTS
  In total, 5224 patients (49.8%) stated that they were satisfied with their treatment. Mean VAS score was 5.1. Only 17% of patients (1789/10,539) gave positive responses at the 4 questions of the ANAES/SFEMC questionnaire. VAS score was high for patients satisfied with their treatment and with good treatment effectiveness. Two VAS thresholds were determined using receiver operating characteristic curves that allowed easy identification, with high sensitivity and specificity, of patients satisfied/dissatisfied with their current treatment and with good/poor treatment effectiveness. Based on EXPERT data, this instrument showed that only 16% of patients using triptans (597/3719) were dissatisfied and reported poor treatment effectiveness, whereas treatment was inadequate for 63% of those using aspirin or nonsteroidal anti-inflammatory drugs (1882/2992), 74% of those using paracetamol or other analgesics (2229/2998), and 53% of those using ergotamine (253/474).
  
  
  CONCLUSIONS
  The new instrument should allow easy identification in general practice of the patients receiving an effective or ineffective acute treatment of migraine and thus facilitate the implementation of treatment guidelines for migraine.
authors: Département d'Evaluation et Traitement de la Douleur, CHU de Nice, France, and INSERM 929 Clermont-Ferrand, France.
authors: Michel
authors: M
authors: Lantéri-Minet
authors: Hélène
authors: H
authors: Massiou
authors: Sophie
authors: S
authors: Romatet
authors: Adeline
authors: A
authors: Barba
authors: Christian
authors: C
authors: Lucas
authors: Bashar
authors: B
authors: Allaf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000523:psychology*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics