title: Treatment adherence among new triptan users: a 2-year cohort study in Taiwan.
abstract: BACKGROUND
  The persistence of triptan use among newly prescribed users is low in the United States and European countries. However, triptan refill patterns in Asian primary care practices have not been well described.
  
  
  METHODS
  Data from the National Health Insurance Research Database in Taiwan were used to conduct a retrospective cohort analysis from 2005 to 2008. All participants were followed for 2 years after receiving a new triptan prescription. Refill and 2-year retention rates of newly prescribed triptans were calculated, and predictors of the first triptan refill and 2-year retention were analyzed.
  
  
  RESULTS
  Of the 13,951 participants with a new triptan prescription (99.9% sumatriptan), 67.4% were prescribed by a neurologist, 67.4% were prescribed at least one prophylactic agent for migraine. Of them, 34.3% adhered to the newly prescribed triptan at the first refill, 0.01% switched to another triptan, and 40.9% switched to a non-triptan acute migraine medication. The 2-year retention rate was 4.0%. The frequency of headache-related neurologic visits for 1 year before the index date, first prescription of triptan or other acute medications, first triptan prescription by a neurologist, and prophylactic use were associated with higher first refill rates. The frequency of headache-related neurologic visits 1 year before the index date and first triptan prescription by a neurologist were related to higher 2-year retention rates. Diabetes mellitus and first triptan prescription at a local medical clinic were associated with reduced probability of continued triptan use at the first refill and 2 years.
  
  
  CONCLUSIONS
  Similar to Western societies, the refill and 2-year retention rates were low in new users of triptans. Frequency of neurologic visits and triptan prescription by a neurologist were significant predictors of adherence.
authors.forename: Ting-Bin
authors.initials: TB
authors.lastname: Chen
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.affiliation: Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No, 201, Sec, 2, Shipai Rd,, Beitou District, Taipei 11217, Taiwan. sjwang@vghtpe.gov.tw.
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D018170:Sumatriptan / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014363:Tryptamines / Q000627:therapeutic use*; D016903:Drug Monitoring
chemical_list: D014363:Tryptamines; D018170:Sumatriptan