Headache Clinic, Neurology Department, Vall d'Hebron University Hospital.
Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Curr Opin Neurol. 2024 Jun 1;37(3):271-282. doi: 10.1097/WCO.0000000000001267. Epub 2024 Mar 26.
This review aims to explore the use of patient-reported outcome measures (PROMs) in migraine. Traditionally assessed through specific features, recent adoption of PROMs allows for a more objective and quantifiable evaluation. PROMs, which are standardized questionnaires collecting health information directly from a patients' perspective, cover various aspects, including migraine specific aspects. The review focuses on delineating the applications and interpretation of commonly used PROMs in migraine research, with an emphasis on their integration in clinical care.
Generic and migraine-specific PROMs play a crucial role in clinical research, particularly in assessing health-related quality of life, disability, impact, and associated comorbidities. Some of these measures are strongly recommended to be used by the International Guidelines and are, in fact, mandated by the FDA for product labeling. Recently, there has been an expansion in the use of PROMs to assess migraine in diverse populations, in particular pediatric patients. However, the application of these measures in clinical care shows considerable heterogeneity, and some have not been validated specifically for migraine. The existing multitude of PROMs, coupled with ongoing development of new ones to better capture patient concerns, creates complexity in their research and clinical application. To address these challenges, it becomes imperative to streamline their use, focusing on those that are more validated and better aligned with the patients' perspective including different populations' needs.
The utilization of PROMs in evaluating migraine enables a more holistic assessment, helps quantify the impact of the disease facilitating change measurement, improves communication between healthcare providers and patients and, guides treatment decisions for improved outcomes. However, the increasing number of PROMs questionnaires, underscores the importance of validating these tools for migraine and, the dynamic nature of the disease makes it relevant to decide with whom, why and when these should be used.
本综述旨在探讨患者报告结局测量(PROMs)在偏头痛中的应用。传统上通过特定特征进行评估,最近采用 PROMs 可进行更客观和可量化的评估。PROMs 是从患者角度收集健康信息的标准化问卷,涵盖了各种方面,包括偏头痛的具体方面。本综述重点阐述了在偏头痛研究中常用 PROMs 的应用和解释,强调了它们在临床护理中的整合。
通用和偏头痛特异性 PROMs 在临床研究中起着至关重要的作用,特别是在评估健康相关生活质量、残疾、影响和相关合并症方面。其中一些措施强烈建议国际指南使用,实际上,美国食品和药物管理局要求将其用于产品标签。最近,PROMs 在评估不同人群中的偏头痛,特别是儿科患者中的应用有所扩大。然而,这些措施在临床护理中的应用存在相当大的异质性,并且有些措施并未专门针对偏头痛进行验证。现有的大量 PROMs,加上为更好地捕捉患者关注点而不断开发的新 PROMs,使得它们的研究和临床应用变得复杂。为了解决这些挑战,必须简化其使用,重点关注那些更经过验证、更符合患者视角的措施,包括不同人群的需求。
在评估偏头痛中使用 PROMs 可以进行更全面的评估,有助于量化疾病的影响,促进变化的测量,改善医疗保健提供者和患者之间的沟通,并指导治疗决策以改善结果。然而,越来越多的 PROMs 问卷强调了验证这些偏头痛工具的重要性,并且疾病的动态性质使得决定何时以及与谁使用这些工具变得相关。