Adherence with migraine prophylaxis in clinical practice
Pain Practice,

Berger A et al. – These findings suggest that many patients who begin migraine prophylaxis with antidepressants, antiepileptics, or beta blockers are no longer taking these medications at 6 months.

Methods
  • Using a large US health insurance claims database (calendar years 2003 to 2005), authros identified all patients with migraine who began prophylaxis with selected antidepressants, antiepileptic drugs, or beta blockers (“study agents”).
  • Patients not continuously enrolled for 6 months prior to start of prophylaxis (“pretreatment”) and for 6 months subsequently (“follow–up”) were excluded.
  • Treatment cohorts were constituted based on the type of prophylaxis received.
  • Adherence with migraine prophylaxis was examined by type of agent received using medication possession ratios (MPRs), defined as total days with medication divided by total follow–up days.
  • MPR < 0.80 was considered indicative of nonadherence.

Results
  • A total of 4,634 patients met all entry criteria and received antidepressants (n = 1,803), antiepileptics (n = 1,896), or beta blockers (n = 935) on their index date.
  • Over the next 6 months, the mean (SD) number of prescriptions for study agents was 2.7 (1.9) for antidepressants, 2.9 (2.0) for antiepileptics, and 2.8 (2.0) for beta blockers, totaling 91.0 (71.4), 98.7 (75.6), and 96.7 (73.0) therapy–days, respectively.
  • Mean MPR at 6 months was 0.48 for antidepressants, 0.51 for antiepileptics, and 0.51 for beta blockers.
  • By the end of the follow–up, 73.4%, 70.2%, and 67.6% of patients who initiated migraine prophylaxis with antidepressants, antiepileptics, and beta blockers, respectively, were designated nonadherent (ie, MPR < 0.80).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Neurology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Neurology Articles

1 A new way to diagnose brain damage from concussions, strokes, and dementia Tufts University News, December 16, 2014

2 Clopidogrel plus aspirin aspirin alone for preventing early neurological deterioration in patients with acute ischemic stroke Journal of Clinical Neuroscience, November 13, 2014    Clinical Article

3 Effect of addition of clopidogrel to aspirin on subdural hematoma: Meta-analysis of randomized clinical trials International Journal of Stroke, December 5, 2014    Evidence Based Medicine    Review Article    Clinical Article

4 Effect of alteplase within 6 hours of acute ischemic stroke on all-cause mortality (Third International Stroke Trial) Stroke, November 26, 2014    Clinical Article

5 Effects of antiplatelet agents on functional outcome and cognitive status in patients with acute ischemic stroke Full Text International Journal of Gerontology, November 21, 2014    Free full text    Clinical Article

6 Antithrombotic therapy after acute ischemic stroke in patients with atrial fibrillation Stroke, November 25, 2014    Clinical Article

7 25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease Stroke, December 24, 2014    Clinical Article

8 Optimal combination secondary prevention drug treatment and stroke outcomes Neurology®, December 9, 2014    Clinical Article

9 Alteplase for the treatment of acute ischaemic stroke: A NICE Single Technology Appraisal; An evidence review group perspective PharmacoEconomics, December 1, 2014    Review Article

10 Prediction of recurrent stroke with ABCD2 and ABCD3 scores in patients with symptomatic 50-99% carotid stenosis Full Text BMC Neurology, December 11, 2014    Free full text    Clinical Article

11 Clopidogrel plus aspirin versus warfarin in patients with stroke and aortic arch plaques Stroke, May 2, 2014    Clinical Article

12 Association of statin use and risk for severe headache or migraine by serum vitamin D status: A cross-sectional population-based study Cephalalgia, December 1, 2014    Clinical Article

13 Effects of differences in serum total homocysteine, folate, and vitamin B12 on cognitive impairment in stroke patients Full Text BMC Neurology, December 4, 2014    Free full text    Review Article

14 Effects of blood pressure lowering in patients with acute ischemic stroke and carotid artery stenosis International Journal of Stroke, December 16, 2014    Clinical Article

15 Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials The Lancet, August 11, 2014    Evidence Based Medicine    Clinical Article

16 Risk of stroke associated with nonsteroidal anti-inflammatory drugs Full Text Vascular Health and Risk Management, January 13, 2014    Free full text    Review Article    Clinical Article

17 Thrombolysis and clinical outcome in patients with stroke after implementation of the Tyrol Stroke Pathway: a retrospective observational study The Lancet Neurology, December 2, 2014    Clinical Article

18 Marijuana use associated with lower death rates in patients with traumatic brain injuries Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center News, November 11, 2014

19 Ischemic stroke and intracranial hemorrhage with aspirin, dabigatran, and warfarin Stroke, December 23, 2014    Clinical Article

20 Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open-label, parallel-group trial International Journal of Stroke, December 10, 2014    Clinical Article

Indexed Journals in Neurology: Current Opinion in Neurology, Stroke, Seizure, Cephalgia, Brain Injurymore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List