Headache: The Journal of Head and Face Pain C 2017 American Headache Society V
Published by JohnWiley & Sons, Inc. doi: 10.1111/head.13181
Associate Provider’s Column A Review of Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States and who started migraine prophylaxis treatment at the start of the 12-month period.7 Patients were grouped into one of three categories of preventive treatment, and so named as these three categories were determined the highest prescribed preventives for migraine: topiramate, beta blockers (including propranolol, metoprolol), and tricyclic antidepressants (including amitriptyline, nortriptyline). Demographic data such as age, gender, geographic location, and insurance type were collected. Also, baseline comorbidities were identified, which included both medical and psychiatric conditions, such as headache, type 2 diabetes, anxiety, and depression. The study outcomes for migraine prophylaxis patterns included the following: (1) gaps (>90 days) in treatment after initiation of preventive medication, (2) treatment discontinuation, (3) switching treatments, and (4) adding treatments. The study outcomes for migraine abortive patterns included the following: (1) timing of treatments utilized after initiation of preventive medication, (2) classes of acute treatments utilized at baseline and at follow-up visit, and (3) number of treatments utilized. After statistical analysis, a total of 107,122 patients met inclusion criteria for this study, and most of these patients fell in the topiramate group at 49%. The mean age was 41 years, the majority of patients were female, and the most common baseline diagnosis was headache. With further review, the researchers found that both persistence and adherence were low. Overall, 81% of patients had a gap in preventive treatment >90 days (mostly just after initiation), and the majority of these patients fell in the tricyclic antidepressant group. Only 10% of patients restarted treatment after this gap. Few patients added a second preventive treatment, few patients switched from one preventive treatment group to another, and 65% of patients were not taking any preventive treatment by 12 months’ time. Also, the most commonly prescribed beta blocker was propranolol and the most commonly prescribed tricyclic antidepressant was
MY PICK For this edition of Headache, I have selected the article: Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States. By Dr. Robert A. Lenz, Amgen Inc. Migraine remains one of the most disabling neurological conditions to afflict the US population, at a strong 12%.1,2 It tends to be categorized as either episodic (
Published by JohnWiley & Sons, Inc. doi: 10.1111/head.13181
Associate Provider’s Column A Review of Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States and who started migraine prophylaxis treatment at the start of the 12-month period.7 Patients were grouped into one of three categories of preventive treatment, and so named as these three categories were determined the highest prescribed preventives for migraine: topiramate, beta blockers (including propranolol, metoprolol), and tricyclic antidepressants (including amitriptyline, nortriptyline). Demographic data such as age, gender, geographic location, and insurance type were collected. Also, baseline comorbidities were identified, which included both medical and psychiatric conditions, such as headache, type 2 diabetes, anxiety, and depression. The study outcomes for migraine prophylaxis patterns included the following: (1) gaps (>90 days) in treatment after initiation of preventive medication, (2) treatment discontinuation, (3) switching treatments, and (4) adding treatments. The study outcomes for migraine abortive patterns included the following: (1) timing of treatments utilized after initiation of preventive medication, (2) classes of acute treatments utilized at baseline and at follow-up visit, and (3) number of treatments utilized. After statistical analysis, a total of 107,122 patients met inclusion criteria for this study, and most of these patients fell in the topiramate group at 49%. The mean age was 41 years, the majority of patients were female, and the most common baseline diagnosis was headache. With further review, the researchers found that both persistence and adherence were low. Overall, 81% of patients had a gap in preventive treatment >90 days (mostly just after initiation), and the majority of these patients fell in the tricyclic antidepressant group. Only 10% of patients restarted treatment after this gap. Few patients added a second preventive treatment, few patients switched from one preventive treatment group to another, and 65% of patients were not taking any preventive treatment by 12 months’ time. Also, the most commonly prescribed beta blocker was propranolol and the most commonly prescribed tricyclic antidepressant was
MY PICK For this edition of Headache, I have selected the article: Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States. By Dr. Robert A. Lenz, Amgen Inc. Migraine remains one of the most disabling neurological conditions to afflict the US population, at a strong 12%.1,2 It tends to be categorized as either episodic (
