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Comparison of Expected Outcomes between Patients and Neurologists Using Kano’s Methodology in Symptomatic Migraine Treatment

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Abstract

Objectives

Our objective was to evaluate the potential usefulness of the Kano conceptual model to assess expectations of patients and neurologists in Spain regarding symptomatic migraine treatment.

Methods

We performed a multicenter, cross-sectional study in adult migraine patients with at least 1 year of disease evolution and at least one prescription of anti-migraine drugs within the last year. Data collection was performed using questionnaires that included sociodemographic and treatment expectations. Using Kano’s methodology, treatment attributes were classified as the following: Must-be; One-dimensional; Attractive; Indifferent; Reverse; or Questionable.

Results

A total of 204 migraine patients (mean age 39.2 years [SD 11.9]; 84.6% women) and 68 neurologists (mean age 44 years [SD 8.8]; 63.2% men) were surveyed. None of the treatment attributes evaluated by the patients showed a dominant Must-be feature. Among patients and neurologists, the attributes that led to a greater dissatisfaction when absent and that were ranked as the three most important attributes were those related to treatment safety (absence of long-term adverse effects), efficacy (pain relief achievement), and quality of life (possibility of resuming occupational or academic activities). Differences in attributes’ classification were noted among patients and neurologists. The attribute that was considered most important by the patients was achievement of total disappearance of pain, whereas for neurologists the most important attribute was absence of long-term adverse effects.

Conclusions

Kano’s methodology is a useful tool to analyze differences in migraine treatment expectations among patients and neurologists. The main difference between patients and neurologists related to basic priorities. Therefore, when selecting treatment for migraine, physicians should invite the patient to participate in the decision making of which treatment is more appropriate.

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Acknowledgments

All authors on this publication contributed to the study concept and data interpretation. The investigator-initiated project was funded by a restricted grant from Merck Sharp & Dohme. MTC and GN are employees of Merck Sharp & Dohme. JMG has no financial interests directly or indirectly related to the research presented in this article to disclose. JMG is the guarantor for the overall content of this article.

Members of the Research Group on Migraine Evaluation in Spain (MIGREXX study; Tratamiento de la migraña: expectativas y experiencia de los pacientes y de los médicos especialistas en Neurología) are listed in the Appendix, which is available as Supplemental Digital Content, http://links.adisonline.com/PBZ/A37.

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Authors and Affiliations

  1. Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain

    Jorge Matías-Guiu MD

  2. Merck Sharp & Dohme S.A., Madrid, Spain

    M. T. Caloto & G. Nocea

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  1. Jorge Matías-Guiu MD
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  2. M. T. Caloto
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  3. G. Nocea
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Research Group on Migraine Evaluation in Spain (MIGREXX Study)

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Correspondence to Jorge Matías-Guiu MD.

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Matías-Guiu, J., Caloto, M.T., Nocea, G. et al. Comparison of Expected Outcomes between Patients and Neurologists Using Kano’s Methodology in Symptomatic Migraine Treatment. Patient 5, 147–162 (2012). https://doi.org/10.1007/BF03262488

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