6 - Acute Treatment Optimization Influences Disability and Quality of Life in Migraine: Results of the ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) study

¹Department of Neurology, Albert Einstein College of Medicine, Bronx, USA, ²Eli Lilly and Company, Indianapolis, USA (*former employee), ³Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, and Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, USA, ⁴Vedanta Research, Chapel Hill, USA, ⁵Department of Neurological Sciences, Larner College of Medicine, University of Vermont, Burlington, USA, ⁶Montefiore Medical Center, Bronx, NY, USA.

Purpose
Assess the influence of acute treatment optimization and migraine related disability and health related quality of life (HRQoL) across monthly Migraine Headache Day (MHD) categories from the OVERCOME study. Acute treatments for migraine attacks are considered optimized when they resolve pain and restore function. Optimized acute treatment for migraine should be associated with less disability and better HRQoL in people with migraine.
Methods
OVERCOME is a web-based survey conducted in a representative US sample. The current sample, collected in Spring 2019, included 20,041 people meeting ICHD-3 criteria for migraine who completed measures of acute treatment optimization (Migraine Treatment Optimization Questionnaire [mTOQ]), disability (Migraine Disability Assessment Scale [MIDAS], and HRQoL (Migraine-Specific Quality of Life Questionnaire, Role Function – Restrictive subscale [MSQ-RFR]). This analysis examined the relationship between mTOQ, MIDAS, and MSQ-RFR across MHDs per month categories (0-3, 4-7, 8-14, ≥15 MHDs). One-way ANOVA or Chi-square test, stratified by MHD category, evaluated differences between mTOQ groups (p < .05).
Results
For the whole cohort of 20,041 respondents, mean(SD) age was 42.5(14.9) years, 74.9% were female, and 72.1% were non-Hispanic white. Among the 3,938 respondents with 4-7 MHDs per month, 60.1% of those with very poor treatment optimization had severe MIDAS disability as opposed to only 19.5% of those with maximum treatment optimization (p < .001). In this group, those with very poor treatment optimization had significantly lower MSQ-RFR scores, Mean= 32.0 (SD 22.8) relative to those with maximum treatment optimization, Mean= 63.4 (SD 20.7) (p < .001). Significant differences in MIDAS and MSQ-RFR by treatment optimization were observed across all other MHD cohorts (i.e. 0-3, 8-14, ≥15; all p <.001).
Conclusions
When acute migraine treatment is optimized, people with migraine report lower levels of disability and better health related quality of life.