Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance

Abstract Background New treatments are currently offering new opportunities and challenges in clinical management research the migraine field. There is need of homogenous criteria to identify candidates for treatment escalation as well reliable refractoriness treatment. To overcome those issues, European Headache Federation (EHF) issued a Consensus document propose approach difficult-to-treat patients standardized way. The proposed well-defined resistant (i.e., who do not respond some but have residual therapeutic opportunities) refractory still debilitating despite maximal efforts). aim this study was better understand perceived impact attitude physicians involved care toward conditions. Methods We conducted web-questionnaire-based cross-sectional international involving with interest headache care. Results were 277 questionnaires available analysis. A relevant proportion participants reported that frequently seen their practice (49.5% 28.9% migraine); percentages higher when considering only working specialized centers (75% 46% respectively). However, many low or moderate confidence managing (8.1% 43.3%, respectively) (20.7% 48.4%, patients; treating different according level number visited per week. Patients infrequently referred more (12% 19%, respectively); also case, figures Conclusions This report highlights relevance presence unmet needs evidence regarding clear guidance referring organization opportunities.