The use of the Traffic Light of Migraine Action Plan (TRALI-MAP) in Acute Migraine Treatment
Ana-Marisa Lagman-Bartolome1, James Im2, Manav Vyas3, Ian Stanaitis2, Christine Lay2
1Children's Hospital, Western University, 2Women's College Hospital, University of Toronto, 3St. Michael's Hospital, University of Toronto
Objective:
Primary Objective:
Quantitatively examine the effectiveness of TRALI-MAP using the Migraine Treatment Optimization Questionnaire (mTOQ-4).
Secondary Objectives:
Assess the impact of TRALI-MAP using the Migraine Disability Assessment Scale (MIDAS) and Patient Global Impression of Change (PGIC).
Quantitatively evaluate the ease of use and satisfaction in using TRALI-MAP using a modified validated questionnaire.
Background:
Early treatment is critical to minimize a patient’s headache and associated symptoms, but current migraine management tools assess headache pain, not associated disability in a patient-centered manner. The traffic light of migraine action plan (TRALI-MAP) is a novel stratified care strategy developed to close this gap in acute migraine management. This simple tool guides patients to help decide which of the acute treatment options to use based on the severity of their symptoms and the level of disability during a migraine attack.
Design/Methods:
A prospective single-center before-after interventional study was conducted at Women’s College Hospital in Toronto, Canada, to evaluate the acceptability of TRALI-MAP to guide acute treatment of migraine and assess migraine associated disability. We evaluated the usability of TRALI-MAP at their baseline visit, via phone call 4-weeks after initial visit, and at the 1st follow-up visit (generally 2-3 months; phone call or in-person).
Results:
Twenty-eight patients diagnosed with episodic migraine without aura were contacted for recruitment, of whom 20 (71.4%) completed assessments. Mean age 35 years (range: 19-65 years), 90% women and 15% were also diagnosed with medication overuse headache. Overall, participants rated the usability (85%), satisfaction (80%), and usefulness (90%) of the TRALI-MAP positively. Compared to the baseline (55%), the treatment optimization, measured as moderate or maximal response to acute treatment, at the follow-up visit was 100%.
Conclusions:
TRALI-MAP is an acceptable and useful tool in optimizing acute migraine treatment in migraine patients and offers a tool to assess the associated disability of an attack beyond headache.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.