Nett R B, Tiseo P J, Almas M, Sikes C R
Texas Headache Associates, San Antonio, TX, USA.
Int J Clin Pract. 2007 Oct;61(10):1677-85. doi: 10.1111/j.1742-1241.2007.01513.x.
The efficacy of triptans for acute migraine has been well established in clinical trials but not in primary care, where they are most commonly prescribed. The aim of this open-label study was to evaluate the effectiveness of eletriptan 40 mg in primary care, using a patient-weighted satisfaction scale.
Eligible patients met International Headache Society criteria for migraine, with 1-6 attacks per month. Patients completed questionnaires at screening and following a single eletriptan-treated attack. Treatment satisfaction was evaluated using a six-item Medication Satisfaction Questionnaire (MSQ). MSQ item scores were weighted, based on the important score ratings, to yield individualised satisfaction scores. The primary end-point was the difference in weighted satisfaction scores between the patient's previous treatment and eletriptan 40 mg. Secondary end-points assessed quality of life (QOL), functioning and efficacy of treatment.
Of 590 patients screened, 437 completed the study. Degree (95.2%), time (88.8%) and duration (83.8%) of headache pain relief were rated as most important by patients. The mean (+/-SD) total satisfaction score on the MSQ was higher for eletriptan than previous therapy (2.2 +/- 3.0 vs. 0.6 +/- 2.4; p < 0.001). The high level of satisfaction with eletriptan vs. previous treatment reflects the improvements in QOL and functioning observed, and the high headache and pain-free response rates.
Patient-weighted satisfaction with eletriptan 40 mg was higher than with previous treatment for all items. The use of patient-weighted importance ratings of satisfaction is a promising approach for establishing effectiveness of treatment in primary care.
曲坦类药物治疗急性偏头痛的疗效在临床试验中已得到充分证实,但在最常开具此类药物的基层医疗中尚未得到证实。这项开放标签研究的目的是使用患者加权满意度量表评估40毫克依立曲坦在基层医疗中的有效性。
符合条件的患者符合国际头痛协会的偏头痛标准,每月发作1 - 6次。患者在筛选时以及在单次接受依立曲坦治疗的发作后完成问卷调查。使用六项药物满意度问卷(MSQ)评估治疗满意度。根据重要性评分对MSQ项目得分进行加权,以得出个性化的满意度得分。主要终点是患者先前治疗与40毫克依立曲坦之间加权满意度得分的差异。次要终点评估生活质量(QOL)、功能和治疗效果。
在590名接受筛选的患者中,437名完成了研究。患者将头痛疼痛缓解的程度(95.2%)、时间(88.8%)和持续时间(83.8%)评为最重要。依立曲坦在MSQ上的平均(±标准差)总满意度得分高于先前治疗(2.2±3.0对0.6±2.4;p<0.001)。与先前治疗相比,对依立曲坦的高度满意度反映了观察到的生活质量和功能的改善,以及高头痛缓解率和无痛反应率。
对于所有项目,患者对40毫克依立曲坦的加权满意度高于先前治疗。使用患者加权的满意度重要性评分是在基层医疗中确定治疗有效性的一种有前景的方法。