{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:27:13Z","timestamp":1791660433557,"version":"4.3.4"},"posted":{"date-parts":[[2025,4,4]]},"group-title":"Neurology","reference-count":17,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,4,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To summarize the baseline methods for the Headache Assessment Via Digital Platform in United States (Head-US) study and report accuracy of self- reported diagnosis of migraine on the platform, and patterns of acute and preventive treatment use among participants with migraine.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The HeAD-US is a new, ongoing cohort study of patients with migraine in the US, centered around comprehensive data collection via the Migraine Buddy platform, a smartphone app. Data from such platforms can be used to provide real-world insights, capturing patients\u2019 voices directly.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants from the Migraine Buddy app completed baseline surveys assessing demographics, headache characteristics, and treatment use. Migraine diagnosis was determined using the AMS\/AMPP diagnostic module, and treatment effectiveness was evaluated using the migraine Treatment Optimization Questionnaire (mTOQ-6, defined as scores \u2265 6 indicating moderate-to-maximum efficacy).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 6810 participants who completed the baseline questionnaire, 6267 (92.0%) met migraine criteria and were included in the rest of the study. Participants had an average age of 41.5 years (SD=13.1, range 18-88), 5692 (90.8%) were female, 3924 (62.6%) met criteria for episodic migraine and 2343 (37.4%) met criteria for chronic migraine. Of the participants, 52.6% were using acute over-the-counter (OTC) medications, 73.2% were using acute prescription medications, 2.4% were using medical devices, and 60.1% were on preventive treatments. There was no significant difference in treatment effectiveness between participants on polytherapy (37.6%) and those on monotherapy (39.5%, p = 0.168). Among the 2621 patients on monotherapy with acute medications, the most common categories were triptans (39.0%), OTCs (28.2%), and gepants (20.8%). For patients on prescription monotherapy, individuals using gepants reported the highest rate of effective treatment (53.3%) in head-to-head comparison with triptans (47.28%, p=0.036), and opioid\/barbiturates (27.1%, p&lt;0.001).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HeAD-US participants have higher rates of chronic migraine and headache-related disability in comparison with large-scale epidemiologic studies. The HeAD-US study offers a valuable opportunity to leverage real-world data for understanding migraine patients, their treatment patterns, and outcomes.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.04.03.25325136","type":"posted-content","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:42:12Z","timestamp":1743813732000},"source":"Crossref","is-referenced-by-count":4,"title":["Headache Assessment Via Digital Platform in United States (Head-US): Baseline Study Characteristics, Diagnosis, and Treatment Patterns"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1307-4589","authenticated-orcid":false,"given":"Ali","family":"Ezzati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina M.","family":"Fanning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin","family":"Teichrow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Urani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Cadiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Lipton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2025040705250839000_2025.04.03.25325136v1.1","unstructured":"Collaborators GA . Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study. bmj 2022;376."},{"key":"2025040705250839000_2025.04.03.25325136v1.2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1038\/s41582-021-00509-5","article-title":"Diagnosis and management of migraine in ten steps","volume":"17","year":"2021","journal-title":"Nature Reviews Neurology"},{"key":"2025040705250839000_2025.04.03.25325136v1.3","doi-asserted-by":"crossref","first-page":"113958","DOI":"10.1016\/j.addr.2021.113958","article-title":"Connected healthcare: Improving patient care using digital health technologies","volume":"178","year":"2021","journal-title":"Advanced Drug Delivery Reviews"},{"key":"2025040705250839000_2025.04.03.25325136v1.4","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1111\/head.13407","article-title":"Migraine in America Symptoms and Treatment (MAST) study: baseline study methods, treatment patterns, and gender differences","volume":"58","year":"2018","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"2025040705250839000_2025.04.03.25325136v1.5","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414552532"},{"key":"2025040705250839000_2025.04.03.25325136v1.6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1526-4610.2006.00631.x","article-title":"Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study: CME","volume":"47","year":"2007","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"2025040705250839000_2025.04.03.25325136v1.7","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/head.14259","article-title":"Diagnosis, consultation, treatment, and impact of migraine in the US: results of the OVERCOME (US) study","volume":"62","year":"2022","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"2025040705250839000_2025.04.03.25325136v1.8","doi-asserted-by":"crossref","unstructured":"Shewale AR , Poh W , Reed ML , et al. Ubrogepant users\u2019 real-world experience: Patients on ubrogepant, characteristics and outcomes (UNIVERSE) study. Headache: The Journal of Head and Face Pain 2024.","DOI":"10.1111\/head.14839"},{"key":"2025040705250839000_2025.04.03.25325136v1.9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s40120-023-00556-8","article-title":"Real-world use of ubrogepant as acute treatment for migraine with an anti-calcitonin gene-related peptide monoclonal antibody: results from courage","volume":"13","year":"2024","journal-title":"Neurology and Therapy"},{"key":"2025040705250839000_2025.04.03.25325136v1.10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s10194-023-01622-0","article-title":"Real-world effectiveness, satisfaction, and optimization of ubrogepant for the acute treatment of migraine in combination with onabotulinumtoxinA: results from the COURAGE Study","volume":"24","year":"2023","journal-title":"The Journal of Headache and Pain"},{"key":"2025040705250839000_2025.04.03.25325136v1.11","doi-asserted-by":"crossref","first-page":"4184","DOI":"10.1111\/ene.15037","article-title":"Multinational descriptive analysis of the real-world burden of headache using the Migraine Buddy application","volume":"28","year":"2021","journal-title":"European Journal of Neurology"},{"key":"2025040705250839000_2025.04.03.25325136v1.12","first-page":"e2560","article-title":"Simultaneous comparisons of 25 acute migraine medications based on 10 million users\u2019 self-reported records from a smartphone application","volume":"101","year":"2023","journal-title":"Neurology"},{"key":"2025040705250839000_2025.04.03.25325136v1.13","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1046\/j.1526-4610.2001.041007638.x","article-title":"Migraine diagnosis and treatment: results from the American Migraine Study II","volume":"41","year":"2001","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"2025040705250839000_2025.04.03.25325136v1.14","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.50.6.613"},{"key":"2025040705250839000_2025.04.03.25325136v1.15","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4049"},{"key":"2025040705250839000_2025.04.03.25325136v1.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2008.01786.x"},{"key":"2025040705250839000_2025.04.03.25325136v1.17","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.04.03.25325136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:33:12Z","timestamp":1768509192000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.04.03.25325136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1101\/2025.04.03.25325136","relation":{},"subject":[],"published":{"date-parts":[[2025,4,4]]},"subtype":"preprint"}}