Care Among Migraine Patients in a Commercially Insured Population
Abstract Introduction Migraine management is characterized by the poor use of preventive therapy and the overuse of acute medications. An analysis of current treatment patterns in migraineurs is needed to improve care in this patient population. The aim of this study was to describe treatment patter...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-02-01
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| Series: | Neurology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40120-020-00179-3 |
| _version_ | 1827283987884670976 |
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| author | Machaon Bonafede Donna McMorrow Virginia Noxon Pooja Desai Sandhya Sapra Stephen Silberstein |
| author_facet | Machaon Bonafede Donna McMorrow Virginia Noxon Pooja Desai Sandhya Sapra Stephen Silberstein |
| author_sort | Machaon Bonafede |
| collection | DOAJ |
| description | Abstract Introduction Migraine management is characterized by the poor use of preventive therapy and the overuse of acute medications. An analysis of current treatment patterns in migraineurs is needed to improve care in this patient population. The aim of this study was to describe treatment patterns and healthcare utilization of newly diagnosed migraine patients. Methods This was a retrospective observation study of newly diagnosed migraine patients (no indication of migraine in the past year) identified in the IBM MarketScan Commercial Claims and Encounters database from 1 January 2010 to 30 June 2014. The final study population comprised persons aged 18–64 years at index (new diagnosis of migraine) with 12 months of continuous enrollment in an insurance plan with medical and pharmacy benefits pre-index and post-index. Treatment patterns and healthcare resource utilization were assessed during the post-index period (at least 12-months). Results Of the 1,588,666 migraine patients identified in the database as potentially eligible to participate in the study, 284,719 (17.9%) met the final inclusion criteria. Patients generally used acute and preventive therapies to manage migraine attacks, with most patients using preventive therapy (59.1%). However, 67.9% of those using preventive therapy discontinued the current therapy, with a median time to discontinuation of 5 months. Most of the patients who discontinued preventative therapy also used an acute treatment to manage migraine attacks after discontinuation (77.6%), generally in the year following discontinuation (68.4%). Patients on acute therapies were found to use triptans excessively (1.6%) and other non-migraine-specific acute medications for treatment (7.1%). Acute patients were also at risk of opioid dependence (12.0%) and commonly received opioids or barbiturates as first-line therapy (34.1%). Conclusion Newly diagnosed migraine patients are not being properly treated, as indicated by their excessive use of acute therapies and short time on preventive treatment before discontinuation of that treatment. Further study of the reasons why patients discontinue preventive therapy (adverse events, no response, etc.) and continue to excessively use acute treatments once their treatment regimen has been established is needed. |
| first_indexed | 2024-04-24T09:47:37Z |
| format | Article |
| id | doaj.art-5c9ec14b5919412e92bdea5d39c74962 |
| institution | Directory Open Access Journal |
| issn | 2193-8253 2193-6536 |
| language | English |
| last_indexed | 2024-04-24T09:47:37Z |
| publishDate | 2020-02-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Neurology and Therapy |
| spelling | doaj.art-5c9ec14b5919412e92bdea5d39c749622024-04-14T11:33:35ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362020-02-01919310310.1007/s40120-020-00179-3Care Among Migraine Patients in a Commercially Insured PopulationMachaon Bonafede0Donna McMorrow1Virginia Noxon2Pooja Desai3Sandhya Sapra4Stephen Silberstein5IBM Watson HealthIBM Watson HealthIBM Watson HealthAmgenAmgenJefferson Medical CollegeAbstract Introduction Migraine management is characterized by the poor use of preventive therapy and the overuse of acute medications. An analysis of current treatment patterns in migraineurs is needed to improve care in this patient population. The aim of this study was to describe treatment patterns and healthcare utilization of newly diagnosed migraine patients. Methods This was a retrospective observation study of newly diagnosed migraine patients (no indication of migraine in the past year) identified in the IBM MarketScan Commercial Claims and Encounters database from 1 January 2010 to 30 June 2014. The final study population comprised persons aged 18–64 years at index (new diagnosis of migraine) with 12 months of continuous enrollment in an insurance plan with medical and pharmacy benefits pre-index and post-index. Treatment patterns and healthcare resource utilization were assessed during the post-index period (at least 12-months). Results Of the 1,588,666 migraine patients identified in the database as potentially eligible to participate in the study, 284,719 (17.9%) met the final inclusion criteria. Patients generally used acute and preventive therapies to manage migraine attacks, with most patients using preventive therapy (59.1%). However, 67.9% of those using preventive therapy discontinued the current therapy, with a median time to discontinuation of 5 months. Most of the patients who discontinued preventative therapy also used an acute treatment to manage migraine attacks after discontinuation (77.6%), generally in the year following discontinuation (68.4%). Patients on acute therapies were found to use triptans excessively (1.6%) and other non-migraine-specific acute medications for treatment (7.1%). Acute patients were also at risk of opioid dependence (12.0%) and commonly received opioids or barbiturates as first-line therapy (34.1%). Conclusion Newly diagnosed migraine patients are not being properly treated, as indicated by their excessive use of acute therapies and short time on preventive treatment before discontinuation of that treatment. Further study of the reasons why patients discontinue preventive therapy (adverse events, no response, etc.) and continue to excessively use acute treatments once their treatment regimen has been established is needed.https://doi.org/10.1007/s40120-020-00179-3Acute medicationHealthcare utilizationMigrainePreventive medication |
| spellingShingle | Machaon Bonafede Donna McMorrow Virginia Noxon Pooja Desai Sandhya Sapra Stephen Silberstein Care Among Migraine Patients in a Commercially Insured Population Neurology and Therapy Acute medication Healthcare utilization Migraine Preventive medication |
| title | Care Among Migraine Patients in a Commercially Insured Population |
| title_full | Care Among Migraine Patients in a Commercially Insured Population |
| title_fullStr | Care Among Migraine Patients in a Commercially Insured Population |
| title_full_unstemmed | Care Among Migraine Patients in a Commercially Insured Population |
| title_short | Care Among Migraine Patients in a Commercially Insured Population |
| title_sort | care among migraine patients in a commercially insured population |
| topic | Acute medication Healthcare utilization Migraine Preventive medication |
| url | https://doi.org/10.1007/s40120-020-00179-3 |
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