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Experts issue new guidelines for preventing migraines with drugs


3 Star



Experts issue new guidelines for preventing migraines with drugs

Our Review Summary

The story was also silent about costs, did not include an independent perspective, and pulled a quote from a press release from the American Academy of Neurology. Had it covered the topic more thoroughly, this story would probably have been less confused as to why so many patients choose not to prevent headaches merely “by swallowing a few pills.” The issue is far more complex than that.



Why This Matters

Migraine headaches can be debilitating and can last from hours to days per episode.  Although a great deal of emphasis has been placed on their treatment, prevention has been a poor stepchild.  Only about a third of people who suffer from migraines have frequent enough or severe enough episodes to warrant the risks associated with preventive treatments.  But as we know from the article in Neurology, only a small minority of those who could benefit actually do so.  The reasons are likely multiple and include a lack of understanding on the part of the patient or caregiver, economics or side effects to name a few.



Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The cost of migraine prevention drugs was not mentioned and cost is an important consideration.  The costs range from pennies a day for beta blockers to over $300 for a monthly regimen of Trova. Even the guideline authors mentioned cost as a potential barrier.


Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Here’s what the story states: “Neurologists estimate that about 38% of people who suffer from migraines stand to benefit with such a regimen, and studies suggest that as many as half of migraines can be prevented with drugs.”

Thanks to the competing USA Today coverage, we know that this is an overly optimistic assessment, since in that story it was noted that patients may need to try 3 or 4 different drugs, alternative therapies, and lifestyle changes to achieve a 50% reduction in headaches.


Does the story adequately explain/quantify the harms of the intervention?


Although the story was not specific enough on this point, it reminded readers that all drugs “can have side effects or interact with other medications.”  It didn’t mention how serious they might be or how often they might occur. We’ll give the story the benefit of the doubt however since the list of drugs is long and the incidence and severity of the side effects is complicated


Does the story seem to grasp the quality of the evidence?

Not Satisfactory

There is no discussion of how these ratings were developed. There is also no mention of limitations of the studies that formed the basis for the guidelines. The guidelines themselves note, for example, that migraine prevention studies were usually of short duration (often only 12–16 weeks), and so the long-term efficacy of these therapies is uncertain.


Does the story commit disease-mongering?


No disease-mongering.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story noted that 5 of the 6 guideline authors disclosed relationships with drug companies. However, the only source quoted in the article is one of the guideline authors — no independent perspective was included.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Unlike the USA Today story we reviewed, non-drug approaches were not mentioned.  Despite the fact that the story was based on a set of guidelines for drug treatments, we would have liked to have seen a few words on non-pharmacologic approaches including stress reduction, diet, etc.

Does the story establish the availability of the treatment/test/product/procedure?


It’s clear from the story that these drugs are widely available.

Does the story establish the true novelty of the approach?


The story did not oversell the novelty of these drugs.

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure of the extent to which the story relied on a news release.  We do know:

  • a quote attributed to Dr. Silberstein comes from this AAN press release.
  • No other independent sources are referenced.


Total Score: 4 of 9 Satisfactory


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