JAMA : the journal of the American Medical Association
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JAMA
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Randomized Controlled Trial Clinical Trial
Stratified care vs step care strategies for migraine: the Disability in Strategies of Care (DISC) Study: A randomized trial.
Various guidelines recommend different strategies for selecting and sequencing acute treatments for migraine. In step care, treatment is escalated after first-line medications fail. In stratified care, initial treatment is based on measurement of the severity of illness or other factors. These strategies for migraine have not been rigorously evaluated. ⋯ Our results indicate that as a treatment strategy, stratified care provides significantly better clinical outcomes than step care strategies within or across attacks as measured by headache response and disability time. JAMA. 2000;284:2599-2605.