Rationale for Correct Answer

The correct answer is: Fewer than half of participants eligible for migraine preventative treatment in the OVERCOME study were taking it

The Landmark study aimed to evaluate the premise that a stable pattern of episodic, disabling headaches with a normal physical exam should be diagnosed as migraine in the absence of contradictory evidence. Results from this study revealed that 94% of patients with a physician diagnosis of nonmigraine primary headaches or a new clinic diagnosis of migraine had either IHS-defined migraine (76%) or probable migraine (18%) headache based on longitudinal diary data. The study’s authors recommend using a diary to confirm a primary headache diagnosis when there is doubt or when assigning a non-migraine diagnosis.1

In the Chronic Migraine Epidemiology and Outcomes Study (CaMEO) 67.5% of participants received an accurate diagnosis after a medical consultation. The authors noted that participants with chronic migraine diagnosed with “migraine” were scored as an inaccurate diagnosis. Sinus (49.1% EM, 47.4% CM), stress (43.8% EM, 45.6% CM), and tension-type headaches (31.4% EM, 37.8% CM) were the most common alternative diagnoses.2

CaMEO respondents met the criteria for acute medication overuse in 17.7% of cases. Commonly used acute treatment medications included simple and combination analgesics, with opioids, simple and combination analgesics showing the highest rates of overuse.3

In the 2018 ObserVational survey of the Epidemiology, tReatment and Care of MigrainE (OVERCOME)(US) study, despite 40% (8539/21,143) of respondents being eligible for migraine preventive treatment, only 17% (3555 of 22,143) were actively taking a preventive treatment.4

1. Tepper SJ, et al. Headache. 2004;44(9):856-64;
2. Buse DC, et al. Headache. 2021;61(4):628-41;
3. Schwedt TJ, et al. Neurol Clin Pract. 2021;11(3):216-26;
4. Lipton RB, et al. Headache. 2022;62(2):122-40.