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Effective Health Care Program

Preventive Pharmacological Treatments for Migraine in Adults: Future Research Needs

Systematic Review

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Archived: This report is greater than 3 years old. Findings may be used for research purposes, but should not be considered current.

This report is from AHRQ's series on Future Research Needs Projects.


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).