Triptans for Acute Migraine Headache - Current Experience With Triptan Use and Prescription Habits in a Tertiary Care Headache Outpatient Clinic: An Observational Study

TY - JOUR

T1 - Triptans for Acute Migraine Headache - Current Experience With Triptan Use and Prescription Habits in a Tertiary Care Headache Outpatient Clinic: An Observational Study

AU - Fischer, Marlene

AU - Frank, Florian

AU - Wille, Georg

AU - Klien, Stephanie

AU - Lackner, Peter

AU - Broessner, Gregor

N1 - © 2016 American Headache Society.

PY - 2016/6

Y1 - 2016/6

N2 - 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.

AB - 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.

U2 - 10.1111/head.12820

DO - 10.1111/head.12820

M3 - SCORING: Journal article

C2 - 27091593

VL - 56

SP - 952

EP - 960

JO - HEADACHE

JF - HEADACHE

SN - 0017-8748

IS - 6

ER -