Abstract Details

Title Patient Reluctance as a Possible Barrier to Taking Migraine Preventive Medications: Results of the OVERCOME (US) Study

Topic Headache

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-004

Objective To determine the reasons for non-adoption of migraine preventive medications.

Background

Despite being eligible for preventive migraine treatment, many people with migraine have never taken preventive medications for various reasons.

Design/Methods A representative sample of US adults with migraine was identified from the web-based OVERCOME (US) study, via a self-reported, validated diagnostic questionnaire using the International Classification of Headache Disorders, 3^rd edition criteria. Based on the American Headache Society 2021 consensus statement¹, people with ≥6 monthly headache days (MHDs), 4-5 MHDs with Migraine Disability Assessment (MIDAS) ≥11 (moderate disability), or 3 MHDs with MIDAS ≥21 (severe disability), were considered eligible to receive migraine preventive treatment. People who never received a preventive medication for migraine were asked to select all that apply from a list of 16 reasons why they had “never taken a prescription medication to prevent or reduce the frequency, severity, or duration” of their migraine or severe headaches.

Results

Among 59,001 people with migraine identified in OVERCOME (US), 37.7% (n=22,249) were eligible for migraine preventive treatment. Despite eligibility, 65.3% (n=14,534) had never taken a preventive medication for migraine; their mean age was 40.3 years, they had migraine for a mean of 18.4 years, 79.4% were female, and 82.2% were Caucasian. Half (49.9%) of this group selected only one reason for never having taken migraine prevention, 21.4% selected two, and 28.7% selected ≥3 reasons. The top three reasons selected were (a) ‘I am concerned about side effects of medications/the effects of using them too often’ (25.5%), (b) ‘I do not like taking prescription medications’ (23.3%), and (c) ‘The other medications I use work well enough’ (20.8%).

Conclusions

Despite meeting the eligibility criteria for preventive migraine treatment, a majority of these people had never taken migraine preventive medication. Understanding the reasons may help clinicians address the concerns of these patients.

¹Ailani et al 2021;61(7):1021-1039.

Authors/Disclosures
Elizabeth Johnston PRESENTER	Elizabeth Johnston has stock in Eli Lilly.
Jessica Ailani, MD, FAAN (Medstar Georgetown Neurology)	Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Ailani has received personal compensation in the range of $0-$499 for serving as a Consultant for Eli Lilly. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merz. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aspya. Dr. Ailani has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bausch. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kallyope. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Self Magazine. The institution of Dr. Ailani has received research support from Ipsen. The institution of Dr. Ailani has received research support from Parema. The institution of Dr. Ailani has received research support from Lundbeck. The institution of Dr. Ailani has received research support from Merz. The institution of Dr. Ailani has received research support from Pfizer. Dr. Ailani has received research support from Mi-Helper. The institution of Dr. Ailani has received research support from ShiraTronic. Dr. Ailani has a non-compensated relationship as a Executive Board Member with American Headache Society that is relevant to AAN interests or activities.
Eva J. Muenzel, MD, PhD (Eli Lilly & Co)	Dr. Muenzel has received personal compensation for serving as an employee of Eli Lilly and Company.
Helen Hochstetler, PharmD (Lilly USA)	Helen Hochstetler, PharmD has received personal compensation for serving as an employee of Eli Lilly and Company. Helen Hochstetler, PharmD has received stock or an ownership interest from Eli Lilly and Company.
Betzaida Martinez, PharmD (Eli Lilly)	Dr. Martinez has received personal compensation for serving as an employee of Eli Lilly and Company. Dr. Martinez has stock in Eli Lilly and Company.
Rose Okonkwo	No disclosure on file
Robert A. Nicholson, PhD (Eli Lilly & Company)	Dr. Nicholson has received personal compensation for serving as an employee of Eli Lilly & Company. Dr. Nicholson has stock in Eli Lilly & Company. Dr. Nicholson has received intellectual property interests from a discovery or technology relating to health care.
Bert B. Vargas, MD, FAAN (Eli Lilly and Company)	Dr. Vargas has received personal compensation for serving as an employee of Lilly USA. Dr. Vargas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Football League. Dr. Vargas has or had stock in Eli Lilly. An immediate family member of Dr. Vargas has or had stock in Pfizer.Dr. Vargas has received personal compensation in the range of $500-$4,999 for serving as a Unaffiliated Neurotrauma Consultant with National Football League. Dr. Vargas has received personal compensation in the range of $10,000-$49,999 for serving as a Neurotrauma Consultant with National Association for Stock Car Auto Racing.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.

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