In a new study, researchers have found that anticonvulsants and triptans for a menstrual migraine (MM) were less frequently prescribed by primary care physicians (PCPs) compared with speciality care physicians. There were no significant differences in the prescription patterns of beta-blockers and antidepressants between PCPs and speciality care physicians. These findings could help address prescription patterns of preventive medications for a migraine in primary care settings.
A migraine is a common, chronic, and disabling disease characterized by attacks of severe headaches. In the U.S. population, the prevalence of a migraine has been estimated to be approximately 18% and 6% in women and men, respectively.
The aims of preventive medications are to decrease the frequency, duration, or severity of attacks, enhance the response to acute treatments, prevent progression to a chronic migraine, and reduce the overall treatment costs.
Preventive medications have been shown to improve the health-related quality of life and the associated health-outcome decrease. Many adults with a migraine who require preventive therapy are often not prescribed the proper medications.
The most likely reason is that primary care physicians are unacquainted with preventive medications for a migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States.
Patients who were 18 years or older and diagnosed with a migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of a menstrual migraine, and other triptans for acute treatment.
Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits.
Anticonvulsants and triptans for menstrual migraine were less frequently prescribed by primary care physicians compared with speciality care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and speciality care physicians.
Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of the certain type of preventive medications between primary care physicians and speciality care physicians.