title: Comparison of expected outcomes between patients and neurologists using Kano's methodology in symptomatic migraine treatment.
abstract: OBJECTIVE
  Our objective was to evaluate the potential usefulness of the Kano conceptual model to assess expectations of patients and neurologists in Spain regarding symptomatic migraine treatment.
  
  
  METHODS
  We performed a multicenter, cross-sectional study in adult migraine patients with at least 1 year of disease evolution and at least one prescription of anti-migraine drugs within the last year. Data collection was performed using questionnaires that included sociodemographic and treatment expectations. Using Kano's methodology, treatment attributes were classified as the following: Must-be; One-dimensional; Attractive; Indifferent; Reverse; or Questionable.
  
  
  RESULTS
  A total of 204 migraine patients (mean age 39.2 years [SD 11.9]; 84.6% women) and 68 neurologists (mean age 44 years [SD 8.8]; 63.2% men) were surveyed. None of the treatment attributes evaluated by the patients showed a dominant Must-be feature. Among patients and neurologists, the attributes that led to a greater dissatisfaction when absent and that were ranked as the three most important attributes were those related to treatment safety (absence of long-term adverse effects), efficacy (pain relief achievement), and quality of life (possibility of resuming occupational or academic activities). Differences in attributes' classification were noted among patients and neurologists. The attribute that was considered most important by the patients was achievement of total disappearance of pain, whereas for neurologists the most important attribute was absence of long-term adverse effects.
  
  
  CONCLUSIONS
  Kano's methodology is a useful tool to analyze differences in migraine treatment expectations among patients and neurologists. The main difference between patients and neurologists related to basic priorities. Therefore, when selecting treatment for migraine, physicians should invite the patient to participate in the decision making of which treatment is more appropriate.
authors.affiliation: Department of Neurology, Hospital Clnico San Carlos, Madrid, Spain. inc.hcsc@salud.madrid.org
authors.forename: J
authors.initials: J
authors.lastname: Matías-Guiu
authors.forename: M T
authors.initials: MT
authors.lastname: Caloto
authors.forename: G
authors.initials: G
authors.lastname: Nocea
mesh_terms: D000041:Absenteeism; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D009462:Neurology / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy; D017060:Patient Satisfaction; D011788:Quality of Life; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014363:Tryptamines / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D014363:Tryptamines