Skip to main content

How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians.

Publication ,  Journal Article
Lipton, RB; Cutrer, FM; Goadsby, PJ; Ferrari, MD; Dodick, DW; McCrory, D; Liberman, JN; Williams, P
Published in: Curr Med Res Opin
March 2005

BACKGROUND: In treating migraine sufferers, physicians can choose from among seven triptans with different attributes. OBJECTIVE: To develop a system for selecting an oral triptan based on treatment priorities of migraine sufferers, neurologists, and primary care physicians (PCPs) in the United States, and evidence-based performance of triptans in clinical trials. METHODS: The TRIPSTAR project combines data on the treatment preferences of migraineurs and physicians with results from a meta-analysis of individual triptans, which evaluated their effectiveness on various clinical endpoints. Telephone interviews with migraine sufferers, neurol ogists, and PCPs were conducted to elicit individual views on the relative importance of a prespecified set of acute treatment outcomes. Four hundred and fifteen migraine sufferers, both triptan-experienced and triptan-naive, were interviewed. Also, 200 board-certified neurologists and 200 PCPs provided information on migraine patients from their clinical practice. A multiattribute decision model for selecting an oral triptan was constructed using attribute importance weights collected at telephone interview and the meta-analysis data, which were drawn from 53 clinical trials of 6 oral triptans. RESULTS: Efficacy attributes were rated significantly more important than tolerability or consistency in selecting an oral triptan, according to migraine sufferers and physicians. Freedom from cardiovascular adverse events was the most important tolerability attribute, according to migraine sufferers and physicians alike. Pain free at 1 h was the most important lower-level efficacy attribute for migraine sufferers, while sustained pain free was most important for physicians. When weighted treatment attributes were combined with meta-analysis data in a multi-attribute decision model, almotriptan 12.5 mg, eletriptan 80 mg, and rizatriptan 10 mg were significantly closer to the hypothetical ideal triptan than was suma triptan 100 mg. Triptans selected by the model were generally closer to the patient-specific ideal triptan than were the triptans prescribed by physicians. CONCLUSIONS: Almotriptan, eletriptan, and rizatriptan were the three triptans closest to the ideal, from the perspectives of migraine sufferers, PCPs, and neurologists alike. The TRIPSTAR model may be a potentially useful decision-support tool to help physicians select the triptan most likely to produce a successful outcome in migraine sufferers.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Curr Med Res Opin

DOI

ISSN

0300-7995

Publication Date

March 2005

Volume

21

Issue

3

Start / End Page

413 / 424

Location

England

Related Subject Headings

  • Serotonin Receptor Agonists
  • Primary Health Care
  • Physician's Role
  • Patient Satisfaction
  • Pain
  • Neurology
  • Migraine Disorders
  • Middle Aged
  • Male
  • Indoles
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lipton, R. B., Cutrer, F. M., Goadsby, P. J., Ferrari, M. D., Dodick, D. W., McCrory, D., … Williams, P. (2005). How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians. Curr Med Res Opin, 21(3), 413–424. https://doi.org/10.1185/030079905X36387
Lipton, R. B., F. M. Cutrer, P. J. Goadsby, M. D. Ferrari, D. W. Dodick, D. McCrory, J. N. Liberman, and P. Williams. “How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians.Curr Med Res Opin 21, no. 3 (March 2005): 413–24. https://doi.org/10.1185/030079905X36387.
Lipton RB, Cutrer FM, Goadsby PJ, Ferrari MD, Dodick DW, McCrory D, et al. How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians. Curr Med Res Opin. 2005 Mar;21(3):413–24.
Lipton, R. B., et al. “How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians.Curr Med Res Opin, vol. 21, no. 3, Mar. 2005, pp. 413–24. Pubmed, doi:10.1185/030079905X36387.
Lipton RB, Cutrer FM, Goadsby PJ, Ferrari MD, Dodick DW, McCrory D, Liberman JN, Williams P. How treatment priorities influence triptan preferences in clinical practice: perspectives of migraine sufferers, neurologists, and primary care physicians. Curr Med Res Opin. 2005 Mar;21(3):413–424.

Published In

Curr Med Res Opin

DOI

ISSN

0300-7995

Publication Date

March 2005

Volume

21

Issue

3

Start / End Page

413 / 424

Location

England

Related Subject Headings

  • Serotonin Receptor Agonists
  • Primary Health Care
  • Physician's Role
  • Patient Satisfaction
  • Pain
  • Neurology
  • Migraine Disorders
  • Middle Aged
  • Male
  • Indoles