Health care utilization in patients with migraine: demographics and patterns of care in the ambulatory setting.
BACKGROUND
Migraine affects people of all races and both sexes. Migraineurs suffer both financial losses and impaired quality of life. Recent progress in the treatment of migraine has not been made readily available to all who suffer the condition.


OBJECTIVE
To assess outpatient health care delivery patterns for migraine sufferers in the United States.


METHODS
National Ambulatory Medical Care Survey data from 1990 to 1998 was used to assess the demographics of patients seen with a diagnosis of migraine, the types of physicians they saw, and the medications used to treat migraine.


RESULTS
Women accounted for 79% of visits for migraines and whites for 91% of the visits. There was a dramatic increase in the number of migraine visits during the study period, from 9.4 visits per 1000 people in 1990 to 18 visits per 1000 in 1998. Primary care physicians saw the majority of patients (72.2%). Butalbital/aspirin/caffeine was the drug most commonly prescribed for migraine treatment, followed by acetaminophen/dichloralphenazone/isometheptene mucate, propranolol, and sumatriptan.


CONCLUSIONS
Perhaps in part due to newer treatment options, the number of visits for the treatment of migraine doubled over the study interval. Even so, most patients with migraine continue to be treated with older and presumably less effective medications.
Gibbs
Trevor S
TS
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Fleischer
Alan B
AB
Feldman
Steven R
SR
Sam
Maria C
MC
O'Donovan
Cormac A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data; D015995:Prevalence; D013038:Specialization; D014481:United States / Q000453:epidemiology