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Utilization of Preventive Therapy in Korean Migraine Patients

  • Kim, Yewon (College of Pharmacy, Pusan National University) ;
  • Park, Susin (College of Pharmacy, Pusan National University) ;
  • Kim, Eonjeong (College of Pharmacy, Pusan National University) ;
  • Je, Nam Kyung (College of Pharmacy, Pusan National University)
  • Received : 2020.12.10
  • Accepted : 2021.02.10
  • Published : 2021.03.31

Abstract

Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.

Keywords

References

  1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390(10100):1211-59. https://doi.org/10.1016/S0140-6736(17)32154-2
  2. Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007;68(5):343-9. https://doi.org/10.1212/01.wnl.0000252808.97649.21
  3. Kim BK, Chu MK, Lee TG, Kim JM, Chung CS, Lee KS. Prevalence and impact of migraine and tension-type headache in Korea. J Clin Neurol 2012;8(3):204-11. https://doi.org/10.3988/jcn.2012.8.3.204
  4. Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache 2015;55 Suppl 2:103-22; quiz 123-6. https://doi.org/10.1111/head.12505_2
  5. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia 2018;38(1):1-211.
  6. Silberstein SD, Winner PK, Chmiel JJ. Migraine preventive medication reduces resource utilization. Headache 2003;43(3):171-8. https://doi.org/10.1046/j.1526-4610.2003.03040.x
  7. Lee K-S. The diagnosis and most-updated therapy of migraine. J Korean Med Assoc 2009;52(5):500-6. https://doi.org/10.5124/jkma.2009.52.5.500
  8. Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: The American headache society evidence assessment of migraine pharmacotherapies. Headache 2015;55(1):3-20. https://doi.org/10.1111/head.12499
  9. Tfelt-Hansen PC. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2013;80(9):869-70. https://doi.org/10.1212/01.wnl.0000427909.23467.39
  10. Kim L, Kim JA, Kim S. A guide for the utilization of health insurance review and assessment service national patient samples. Epidemiol health 2014;36:e2014008.
  11. Ford JH, Jackson J, Milligan G, Cotton S, Ahl J, Aurora SK. A realworld analysis of migraine: A cross-sectional study of disease burden and treatment patterns. Headache 2017;57(10):1532-44. https://doi.org/10.1111/head.13202
  12. Vo P, Gao W, Zichlin ML, et al. Real-world healthcare resource utilization related to migraine treatment failure: a panel-based chart review in France, Germany, Italy, and Spain. J Med Econ 2019;22(9):953-9. https://doi.org/10.1080/13696998.2019.1636051
  13. Piccinni C, Cevoli S, Ronconi G, et al. A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. J Headache Pain 2019;20(1):74. https://doi.org/10.1186/s10194-019-1027-7
  14. Devine J, Hadsall R, Cline R, Schommer J, Virnig B. Effect of daily migraine prevention on health care utilisation in an insured patient population. J Headache Pain 2007;8(2):105-13. https://doi.org/10.1007/s10194-007-0369-8
  15. Diamond S, Bigal ME, Silberstein S, Loder E, Reed M, Lipton RB. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache 2007;47(3):355-63. https://doi.org/10.1111/j.1526-4610.2006.00631.x
  16. Caetano A, Ladeira F, Mendonca M, et al. Underuse of prophylactic treatment among Portuguese patients with primary headache: A retrospective observational study. J Oral Facial Pain Headache 2019;33(3):331-6. https://doi.org/10.11607/ofph.2122
  17. Lipton RB, Stewart WF, Simon D. Medical consultation for migraine: results from the American Migraine Study. Headache 1998;38(2):87-96. https://doi.org/10.1046/j.1526-4610.1998.3802087.x
  18. Steiner T, Scher A, Stewart W, Kolodner K, Liberman J, Lipton R. The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity. Cephalalgia 2003;23(7):519-27. https://doi.org/10.1046/j.1468-2982.2003.00568.x
  19. Silberstein SD, Dodick D, Freitag F, et al. Pharmacological approaches to managing migraine and associated comorbidities--clinical considerations for monotherapy versus polytherapy. Headache 2007;47(4):585-99. https://doi.org/10.1111/j.1526-4610.2007.00760.x
  20. Rahimtoola H, Buurma H, Tijssen CC, Leufkens HG, Egberts AC. Incidence and determinants of migraine prophylactic medication in the Netherlands. Eur J Clin Pharmacol 2002;58(2):149-55. https://doi.org/10.1007/s00228-002-0443-8
  21. Passmore AP, Crawford VLS, Beringer TRO, Gilmore DH, Montgomery A. Determinants of drug utilization in an elderly population in North and West Belfast. Pharmacoepidemiol Drug Saf 1995;4(3):147-60. https://doi.org/10.1002/pds.2630040307
  22. Silberstein SD. Comprehensive management of headache and depression. Cephalalgia 1998;18 Suppl 21:50-5. https://doi.org/10.1177/0333102498018S2113
  23. Radat F, Sakh D, Lutz G, el Amrani M, Ferreri M, Bousser MG. Psychiatric comorbidity is related to headache induced by chronic substance use in migraineurs. Headache 1999;39(7):477-80. https://doi.org/10.1046/j.1526-4610.1999.3907477.x
  24. Sheftell FD, Feleppa M, Tepper SJ, Volcy M, Rapoport AM, Bigal ME. Patterns of use of triptans and reasons for switching them in a tertiary care migraine population. Headache 2004;44(7):661-8. https://doi.org/10.1111/j.1526-4610.2004.04124.x
  25. Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci 2013;40(5 Suppl 3):S1-S80. https://doi.org/10.1017/S0317167100118943
  26. Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol 2009;16(9):968-81. https://doi.org/10.1111/j.1468-1331.2009.02748.x
  27. Tepper S, D'Amico D, Baos V, Blakeborough P, Dowson A. Guidelines for prescribing prophylactic medications for migraine: A survey among headache specialist physicians in different countries. Headache Care 2004;1(4):267-72. https://doi.org/10.1185/174234304X14872
  28. Steiner TJ, Martelletti P. Aids for management of common headache disorders in primary care. J Headache Pain 2007;8 Suppl 1:S2.
  29. Kim Y, Suh YK, Choi H. BMI and metabolic disorders in South Korean adults: 1998 Korea National Health and Nutrition Survey. Obes Res 2004;12(3):445-53. https://doi.org/10.1038/oby.2004.50
  30. D'Amico D, Lanteri-Minet M. Migraine preventive therapy: Selection of appropriate patients and general principles of management. Expert Rev Neurother 2006;6(8):1147-57. https://doi.org/10.1586/14737175.6.8.1147