Differences in Patient-Physician Satisfaction for Migraine Treatment Medications in Patients with and without Medication-Overuse Headache: A Cross-Sectional Real-World Survey.

Introduction: Medication overuse headache (MOH) is incurred by the excessive use of acute medications, including over-the-counter (OTC) treatments. This study aimed to characterize the burden, management, and treatment satisfaction of patients with migraine with or without MOH in Japan.

Methods: Data were derived from the Adelphi Migraine Disease Specific Programme (DSP)™, a cross-sectional survey conducted in Japan from August 2023 to February 2024. Physicians provided data for consecutive patients, including demographics, clinical characteristics, current treatment, OTC treatment usage, and treatment satisfaction. Patients voluntarily reported their symptom burden, migraine pain severity, and treatment satisfaction. Alignment between physician and patient regarding treatment satisfaction was assessed using Cohen's weighted kappa statistics and multivariable regression models.

Results: Overall, 122 physicians provided data for 820 patients with migraine, 7.0% (n = 57) of whom had a diagnosis of MOH; 41.5% (n = 340) of patients self-reported data, with 3.2% (n = 11) having a diagnosis of MOH. Patients with MOH were more likely to experience chronic migraine (79%, n = 45), greater migraine frequency, and more severe migraine than those without MOH. Ninety percent of both groups received acute treatment. Patients with MOH were significantly more likely to receive preventive treatment than those without MOH (86% vs 56.6%, p < 0.001). OTC medication use was reported at 3.3% by physicians and 11.2% by patients. The alignment between physician and patient treatment satisfaction was low for acute treatment. The exploratory model analysis indicated that OTC use may have contributed to this misalignment.

Conclusion: Our study revealed that the alignment regarding treatment satisfaction with acute medications is low. OTC treatment usage may have inflated physician satisfaction with prescribed acute medications and caused a discrepancy regarding satisfaction of patients with MOH. To improve patient outcomes, it is essential to align drug effectiveness ratings between physicians and patients by enhancing communication and mutual understanding.