title: Migraine prophylactic medication usage patterns in The Netherlands.
abstract: 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.
authors.affiliation: Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands. h.rahimtoola@pharm.uu.nl
authors.forename: H
authors.initials: H
authors.lastname: Rahimtoola
authors.forename: H
authors.initials: H
authors.lastname: Buurma
authors.forename: C C
authors.initials: CC
authors.lastname: Tijssen
authors.forename: H G
authors.initials: HG
authors.lastname: Leufkens
authors.forename: A C G
authors.initials: AC
authors.lastname: Egberts
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D002121:Calcium Channel Blockers; D004338:Drug Combinations; D004879:Ergotamines; D012702:Serotonin Antagonists; D003000:Clonidine