Migraine prophylactic medication usage patterns in The Netherlands.
This study aims to investigate usage patterns of specific migraine prophylactic medications in ergotamine and triptan patients commencing this treatment for the first time during 1 January 1992 until 31 December 1998. Usage patterns of specific migraine prophylactic drugs were evaluated for each patient by accessing data from a large prescription database and were characterized as continued, switch or stop use during the patient observation period. Several patient and medication-related factors were explored in order to identify a possible relationship with the specific usage pattern defined. Approximately 75% of the study population (n = 729) had terminated (stop or switch) prophylactic treatment after 1 year. Age < 40 years (relative risk (RR) 1.9; 95% confidence interval (CI) 1.2-3.2) and the concomitant use of non-steroidal anti-inflammatory drugs (RR 3.2; 95% CI 1.2-5.5) or specific abortive migraine drugs resulted in a faster onset of treatment modification (switch). Overall, migraine prophylactic treatment is used for a relatively short period, probably attributable to the common limitations associated with migraine prophylaxis, such as poor compliance and/or limited therapeutic efficacy. Patterns of use can be influenced by a variety of factors, including age, type of prescriber and certain co-medication. Patient interview studies are required to clarify these issues further.
Rahimtoola
H
H
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands. h.rahimtoola@pharm.uu.nl
Buurma
H
H
Tijssen
C C
CC
Leufkens
H G
HG
Egberts
A C G
AC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003000:Clonidine / Q000627:therapeutic use; D004338:Drug Combinations; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D004879:Ergotamines / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control*; D009426:Netherlands / Q000453:epidemiology; D017891:Pharmacoepidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012702:Serotonin Antagonists / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D002121:Calcium Channel Blockers; D004338:Drug Combinations; D004879:Ergotamines; D012702:Serotonin Antagonists; D003000:Clonidine