Patients-reported desirable features and outcomes in migraine therapeutics and guidance for medical product life cycle: a scoping review of 6435 patients

Abstract

Background

Understanding patient preferences for migraine treatments is essential for patient-centered care and for informing the development and optimization of therapeutic options. Although individual preference-elicitation studies exist, evidence has not been systematically synthesized across methods and treatment contexts.

Methods

We conducted a scoping review in accordance with PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed studies that elicited patient preferences regarding acute or preventive migraine pharmacotherapies. Eligible studies employed qualitative or quantitative preference-elicitation methods.

Results

20 studies comprising 6435 participants were included. Across preventive and acute treatment contexts, efficacy-related outcomes were consistently prioritized by patients. For preventive treatments, key valued attributes included reduction in migraine frequency, durability of effect, tolerability, and convenience, with preferences varying by prior treatment experience and disease severity. For acute treatments, rapid onset of action, complete pain relief, functional recovery, and minimal adverse events were most important. Preferences regarding route of administration were heterogeneous and context-dependent, reflecting trade-offs between convenience, invasiveness, and perceived effectiveness.

Conclusions

Patient preferences for migraine treatments are multifactorial and vary across treatment goals, modalities, and patient subgroups. While methodological limitations across studies constrain definitive conclusions, this review highlights consistent priority attributes that may inform shared decision-making, outcome selection in clinical trials, and patient-centered aspects of migraine therapy development.