title: Acceptance of preventive treatment in migraine patients: results of a survey.
abstract: BACKGROUND
  The number of migraine patients eligible for preventive treatment is considerably higher than the number of patients actually using it. This study explores reasons for this discrepancy.
  
  
  METHODS
  An explorative survey among patients and their general practitioners (GPs) participating in a trial on preventive medication. Migraine patients who were eligible for preventive treatment (n = 75) attended an evaluation consultation with their GP to optimize migraine treatment. GPs and patients who did not start preventive treatment were asked if they had discussed the possibility of preventive treatment and, if so, why they decided not to start it.
  
  
  RESULTS
  Of the 32 GPs, 8 (25%) did not discuss the possibility of preventive treatment with their patients; in 4 because of perceived lack of effectiveness. Patients who did not start preventive treatment (n = 43) used less triptans and had less psychological distress compared to those who did start (n = 32). Main reasons for patients not starting were negative attitudes towards medication in general, fear of medication side-effects, previous unsuccessful attempts, attacks not being severe enough, and impact of migraine on daily life acceptable.
  
  
  CONCLUSIONS
  The decision of the individual patient and their GP to start preventive treatment is not only determined by attack frequency, but also depends on the impact of the headache attacks on their daily life and their negative attitude towards medication.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. a.f.h.smelt@lumc.nl
authors.forename: Antonia F H
authors.initials: AF
authors.lastname: Smelt
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Eijsenga
authors.forename: Willem J J
authors.initials: WJ
authors.lastname: Assendelft
authors.forename: Jeanet W
authors.initials: JW
authors.lastname: Blom
mesh_terms: D000328:Adult; D005260:Female; D058006:General Practice; D058005:General Practitioners; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care