Management Strategies and Outcomes for Migraine within Community Dwelling Adults: A Systematic Review

Abstract

Specific Aims: To describe the pharmacological and non-pharmacological strategies that community dwelling adults use to manage migraine. Methods: PubMed, Embase, Cochrane Library, Web of Science, and Scopus were searched for studies of self-reported migraine management strategies by community dwelling adults aged 18-80 years published in English after 1989. Citation searches and reference list searches for the identified studies also were conducted. Study selection, data extraction, and quality assessment were completed independently by multiple reviewers and differences resolved by consensus. Data were analyzed by constructing summary tables of study characteristics and of the management strategies identified. Main Results: A total of 7757 studies were identified, of which 14 met inclusion criteria. The studies were conducted in eight different countries. The sample size varied from 138 to 3065. The mean age of participants ranged from 35 to 80 years. The mean percent of females was 52. Out of the 14 studies, 9 used self-administered questionnaires and 5 used interviews/telephonic methods. The primary method of treatment in this population was medications, primarily triptans (8-59%), NSAIDS (14.7-59%) and ergotamine’s (0.3-21. 8%). Opioid usage was reported in 5 studies (used by 1-8. 7% of participants). Non-pharmacological strategies for migraine management were reported in only 4 studies. Overall satisfaction with treatment varied from 31.2 to 93.2%. Conclusions: Medications, primarily triptans and NSAIDS, were the primary pharmacological management strategies used by migraineurs. Use of opioids and other non-pharmacological strategies was low. Satisfaction with migraine management varied widely.