title: Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study.
abstract: OBJECTIVE
  To describe the patterns of medical treatment for migraineurs in the United States.
  
  
  BACKGROUND
  Over the past decade, many new treatments for migraine have become available and awareness of migraine has improved. However, there is little information about the patterns of medical treatment in the US society.
  
  
  METHODS
  A validated self-administered headache questionnaire was mailed to a random sample of 120,000 US households. Each household member with severe headaches was asked to complete the survey. The questionnaire assessed headache features, disability, and patterns of medical treatment. Subjects were classified according to their use of headache preventive medication, as current users, coincident users (using effective medications for other medical reasons), lapsed users (had used in the past but not at the time of the survey), or never users.
  
  
  RESULTS
  In 162,576 participants, the prevalence of migraine was 17.1% in women and 5.6% in men. Only 56.2% of those with migraine had ever received a medical diagnosis. Ninety-eight percent of the migraineurs used acute treatment for their migraine attacks. Forty-nine percent (49%) usually used over-the-counters, 20% usually used prescription medications, and 29% used both. Only 12.4% of migraineurs indicated that they were taking a migraine preventive medication, but 17.2% were using medications with potential antimigraine effects for other medical reasons. Current or past use of preventive medication was more likely in women than men (odds ratio [OR] = 1.37, 95% confidence interval [CI] 1.27-1.48), increased with age and individuals with high MIDAS grade (Grade IV vs I, OR 2.35, 95% CI 2.09-2.64). Preventive medication use increased with awareness of migraine and with illness severity.
  
  
  CONCLUSIONS
  Migraine remains undertreated in the US population. Barriers to preventive treatment are greater in younger age groups, men, and people unaware that they have migraine.
authors: Diamond Headache Clinic, Chicago, IL [corrected] USA.
authors: Seymour
authors: S
authors: Diamond
authors: Marcelo E
authors: ME
authors: Bigal
authors: Stephen
authors: S
authors: Silberstein
authors: Elizabeth
authors: E
authors: Loder
authors: Michael
authors: M
authors: Reed
authors: Richard B
authors: RB
authors: Lipton
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States