Excerpt

This Future Research Needs (FRN) project is a followup to the Comparative Effectiveness Review (CER), “Preventive Pharmacologic Treatments for Migraine.” The review was motivated by uncertainty around the effectiveness, comparative effectiveness, and safety of pharmacologic treatments for the prevention of episodic or chronic migraine in adults. To identify research needs, this FRN project used a deliberative process to identify evidence gaps, translate gaps into researchable questions, and solicit stakeholder opinion on the importance of research questions. Addressing these research needs should provide information potentially of value to decisionmakers.

The research questions addressed in the CER relied upon an analytic framework from the original CER. The framework describes a process experienced by adults with episodic or chronic migraine seeking preventative pharmacologic treatments. Differentiating between chronic or episodic migraine according to their clinical definitions depends on headache frequency, frequency of migraine type headaches, the presence of aura, and the possibility of headaches associated with overusing acute pain medication. However, in practice, these categories are often simplified in studies with episodic indicating fewer than 15 headache days per month and chronic indicating 15 or more headache days per month). The review addressed important Key Questions (KQs) about the efficacy and comparative effectiveness of these treatments (KQ 1); evaluating the safety of these treatments (KQ 2); and the identification of patient characteristics that predict the effectiveness and safety of pharmacologic treatments for preventing migraine attacks in adults (KQ 3).

Contents

• Preface
• Stakeholders
• Executive Summary
• Background
  • Context
  • Condition
  • Objective
  • Evidence Gaps and Research Question Development
• Methods
  • Engagement of Stakeholders
  • Handling Conflicts of Interest
  • Refinement of Research Questions
  • Prioritization
  • Research Design Considerations
• Results
  • Research Needs
  • Methodological Research Needs
  • Topical Research Needs
• Discussion
• Conclusions
• References
• Abbreviations
• Appendix A Research Questions for Prioritization
• Appendix B Search Strategy for Ongoing Studies
• Appendix C Ongoing Studies

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10064-I, Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, MN

Suggested citation:

Brasure M, Shamliyan TA, Butler ME, Kane RL, Taylor FR. Preventive Pharmacological Treatments for Migraine in Adults: Future Research Needs. Future Research Needs Paper No. 35. (Prepared by the Minnesota Evidence-Based Practice Center under Contract No. 290-2007-10064-I.) AHRQ Publication No. 13-EHC046-EF. Rockville, MD: Agency for Healthcare Research and Quality. April 2013. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10064-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

None of the investigators have any affiliation or financial involvement that conflicts with the material presented in this report.

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