Triptans for Acute Migraine Headache: Current Experience With Triptan Use and Prescription Habits in a Tertiary Care Headache Outpatient Clinic: An Observational Study.
BACKGROUND
Triptans are recommended as first-line therapy in the acute phase of a migraine attack. We describe patterns of triptan use in a tertiary care headache outpatient clinic, particularly addressing factors that are associated with triptan discontinuation.


METHODS
From December 2009 until August 2012, demographic and clinical data of consecutive patients with migraine were collected. The Headache Impact Test (HIT-6) was used to measure the adverse impact of headaches. Factors associated with triptan discontinuation were analyzed using binary logistic regression.


RESULTS
Of 511 migraine patients included, 73.2% (n = 374) were triptan naïve on first consultation. At follow-up, 57.1% of new triptan users (n = 72/126) reported pain-freedom or pain relief after 2 hours, 40.5% (n = 51/126) did not refill their triptan, another 15.1% (n = 19/126) switched to a different type of triptan. Negative response to triptan treatment and substantial or severe headache impact (HIT-6 score ≥56) at first follow-up were associated with triptan discontinuation (OR 0.39 [95% CI 0.20-0.78], P = .007; OR 3.33 [95% CI 1.10-10.03], P = .033).


CONCLUSIONS
Although triptans have been in clinical use for more than two decades, many migraine sufferers in our study population were found to be triptan naïve on first consultation. The HIT-6 score may be used as an indicator of triptan adherence and help to identify patients at risk for triptan discontinuation.
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).|Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (M. Fischer).
Marlene
M
Fischer
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).
Florian
F
Frank
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).
Georg
G
Wille
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).
Stephanie
S
Klien
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).
Peter
P
Lackner
Headache Outpatient Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria (M. Fischer, F. Frank, G. Wille, S. Klien, P. Lackner, and G. Broessner).
Gregor
G
Broessner
D000208:Acute Disease; D000328:Adult; D011307:Drug Prescriptions; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010045:Outpatients; D012189:Retrospective Studies; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D063128:Tertiary Health Care; D014363:Tryptamines / Q000627:therapeutic use*
D017366:Serotonin Receptor Agonists; D014363:Tryptamines
acute treatment; adherence; discontinuation; headache impact; migraine; responder; triptan