Biomedical subjects

Fatima Nachit-Ouinekh

Publications and source records attributed to Fatima Nachit-Ouinekh.

4 recordsLinked to original sources

PubMed2007

Improvement in quality of life after initiation of lamotrigine therapy in patients with epilepsy in a naturalistic treatment setting.

Quality of life is impaired in patients with epilepsy and can be improved by effective therapy. Randomised clinical trials have shown that lamotrigine treatment is associated with improved quality of life. However, little information is available on quality of life or treatment effects in patients with epilepsy in the general population. The objective of this study was to estimate the impact of lamotrigine on quality of life in a naturalistic treatment setting. The study included adult patients with epilepsy in whom lamotrigine therapy was initiated. Each subject completed the Quality of Life in Epilepsy Inventory (QOLIE)-31 quality of life questionnaire at inclusion and at a follow-up visit in the next 4 months. Demographic information and medical history were provided by the investigator. These were evaluated as potential determinants of change in quality of life using logistic regression. Three hundred and forty-one patients were evaluated, 192 starting lamotrigine in combination with another drug, 90 as a first-line monotherapy, 45 as a switch from another drug and 14 as a reduction to monotherapy from a previous combination. Baseline scores on the QOLIE-31 ranged from 53.8 in the combination group to 69.5 in the first-line group. 34.6% of patients were considered to be responders, with no significant differences between treatment regimen. Most improvement was seen for the energy-fatigue and medication effects subscales and, for the first-line group, seizure worry. Seizure type was the only determinant of improvement of quality of life identified. In conclusion, lamotrigine treatment is associated with improved quality of life, regardless of treatment regimen.

Adolescent↗

PubMed2003

Assessing the severity of migraine: development of the MIGSEV scale.

OBJECTIVES: To identify items that serve to assess the severity of migraine with a high level of clinical and psychometric relevance and to combine these into a unitary severity scale. BACKGROUND: Severity of migraine is an important determinant of patient quality of life and of health care resource utilization. Despite this, no validated method exists for measuring migraine severity. METHODS: After selection from the medical literature items of potential relevance to the severity of migraine, consensus meetings led to a choice of items which subsequently were refined further on the basis of patient interviews. The psychometric properties of those items then were assessed in a survey involving 287 migraineurs. The methods used to test reliability and validity included test-retest, calculation of Cronbach alpha coefficient, analysis of factorial structure using principal components analysis, a comparison of the agreement between doctors' and patients' assessments, and correlation with a validated quality-of-life questionnaire. The most pertinent items revealed by the factorial analysis were combined in a unitary scale. RESULTS: Seven items reflecting severity were identified by expert consensus. These were intensity of pain, tolerability, disability in daily activities, presence of nausea or vomiting, resistance to treatment, duration of attacks, and frequency of attacks. Principal components analysis identified 3 dimensions accounting for 65% of the overall variance related to intensity of attacks, resistance to treatment, and frequency of attacks. The internal consistency and the reproducibility of the items appeared quite satisfactory, and variations in these items were correlated with quality-of-life scores. The 4 items related to intensity of attacks were combined into a single scale with 3 response modalities. CONCLUSIONS: The 3 dimensions identified by this investigation appeared medically relevant and to have good psychometric properties. The items on the intensity dimension can be used to generate a simple scale for assessing migraine attack severity.

Adult↗

PubMedDate not supplied

Evolution of migraine after a 10-year follow-up.

OBJECTIVE: To assess the evolution of headaches in a workplace cohort over a 10-year period. BACKGROUND: Migraine headaches are associated with significant handicap in everyday activities and poor quality of life. The prevalence of migraine shows a bell-shaped age distribution with a peak during the third and fourth decades. However, there is little longitudinal data available on the natural history of this condition. A prospective health survey undertaken in a large workplace cohort since 1989 provides an opportunity to assess the evolution of migraine and other headache syndromes over a 10-year period. METHODS: A sample of 2500 subjects who reported regular headaches was chosen at random from those with headache identified in a cohort of 46,244 employees of the French national power company aged between 35 and 50 years in 1989 participating in a yearly health survey. In 1993, all subjects were sent a headache questionnaire to complete and return. In 2003, an identical questionnaire was sent to all subjects who had returned exploitable data in 1993. Headache diagnosis was assigned retrospectively using the International Headache Society (IHS) criteria to migraine (IHS categories 1.1 and 1.2), migrainous disorder (IHS category 1.7), or other episodic headaches. RESULTS: Of 2500 subjects sampled, 2051 (82%) returned exploitable data for the first questionnaire in 1993. In 2003, 1250 (61%) of these provided a second data set. In 1993, 623 (30.4%) of subjects fulfilled diagnostic criteria for migraine. However, only 37% of these retained the diagnosis 10 years later. In contrast, the proportion of subjects with other forms of episodic headache rose from 23.7% to 31.6%. In 2003, 9.5% of the sample were headache-free. Retention or acquisition of a diagnosis of migraine was more common in women than in men, and age was associated with evolution to a less severe headache syndrome. In those subjects who continued to have headaches, frequency and severity were lower at the second assessment. CONCLUSIONS: Only a minority of subjects diagnosed with migraine or migrainous disorder retain the diagnosis 10 years later, with most subjects evolving to a less disabling headache type.

Adult↗

PubMedDate not supplied

[Triptan use in general practice: a French pharmacoepidemiological study].

This French pharmacoepidemiological study describes triptan use in general practice for triptan 'naive' (never treated by a triptan before study inclusion) and 'non-naive' (already treated by a triptan) patients. Data from 1774 patients were analysed (81% women). The mean age of the patients was 41 years (+/-12.8). This study showed that 95% of the patients had a diagnosis of migraine according to the International Headache Society (IHS) criteria. This result confirmed the effective use of triptans by general practitioners. Migraines in patients treated with triptans in the present study were more severe than in subjects reporting migraine in the general population. 'Naive' and 'non-naive' patients had similar IHS diagnoses and severity profiles but, for 'non-naive' patients, the migraine history was longer and the disability (quality of life) reported was worse than for the 'naive' patients. The reasons for the treatment switch were the need for improved efficacy, a faster onset of action, fewer recurrences and better tolerability.

Adult↗