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Abstract Details

Prophylactic Treatment Patterns Among Patients Diagnosed with Migraine at Tertiary Medical Center and in Tertiary Headache Clinic.
Headache
P3 - Poster Session 3 (12:00 PM-1:00 PM)
7-012
Determine treatment patterns among patients diagnosed with migraine using current best and evidence-based guidelines at a tertiary medical center.
Migraine is one of the most debilitating primary headache disorders with a number of prophylactic medications options.  Research suggests that preventive treatment is underused in migraine treatment. In the analysis preventive treatments included American Headache Society, 好色先生, and Canadian Headache Guidelines are as follows: amitriptyline, beta blockers, topiramate, onabotulinumtoxin A, CGRP receptor antagonists, venlafaxine, valproic acid, candesartan, gabapentin, lisinopril, verapamil, nortriptyline, cyproheptadine, and memantine. 

This observational retrospective database study used the Leaf research database to extract and analyze data in patients diagnosed with migraine without aura, migraine with aura, chronic migraine with aura, other migraine, and migraine unspecified based on ICD-10 codes, and quantified the frequency of prescriptions for prophylactic medication.  CGRP receptor antagonists were not included in this study due to their recent introduction.  Prescribing rates at the UWMC overall and at the specialized Headache Clinic were analyzed using ANOVA.
The most commonly prescribed migraine prophylaxis at UWMC (N=35,388) were beta blockers (23.4%), gabapentin (18.2%), topiramate, (15.3%), and nortriptyline (9.7%).  The most commonly prescribed migraine prophylaxis at the Headache Clinic (N=4,518) were beta blockers (35.5%), topiramate (31.5%), gabapentin (23.0%), and onabotulinumtoxin A (13.8%).  The Headache Clinic more frequently used onabotulinumtoxin A (13.8% vs 3.7%) and memantine (3.0% vs 0.8%) compared to UWMC.  There was no significant difference in prescribing practices for prophylactic medications overall when comparing UWMC and the Headache Clinic (p=0.34).
Actual prescribing practices at a tertiary medical center show underutilization of evidence-based migraine prophylaxis. We recommend using current guidelines for migraine prophylaxis as this is a treatable condition.
Authors/Disclosures
Amita Singh, MD (University of Florida)
PRESENTER 		Dr. Singh has nothing to disclose.
Daniel Krashin, MD (Seattle VA) Dr. Krashin has nothing to disclose.
Natalia Murinova, MD, FAAN (University Of Washington) Dr. Murinova has nothing to disclose.