Abstract Details

Title Acute Medication Overuse in People with Migraine in the United States from the 2021 National Health & Wellness Survey

Topic Headache

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

Poster/Presentation
Number 12-009

Objective To estimate the prevalence of acute medication overuse (AMO) in people with migraine (PwM).

Background AMO is a cycle of high frequency analgesic use, such as triptans and non-steroidal anti-inflammatory drugs (NSAIDs), that may result in medication overuse headache (MOH). There is limited understanding of frequency of use for medication classes across both prescription and over-the-counter drugs.

Design/Methods A retrospective cross-sectional study using the 2021 US National Health and Wellness Survey (NHWS, Cerner Enviza) captured diagnosed PwM with ≥1 acute medication who reported prescription and OTC medication days of use in the past 30 days as well as demographic, migraine, and clinical characteristics. AMO criteria were: 1) ≥10 days of triptans, combination analgesics, ergotamines, or opioids; or 2) ≥15 days of nonopioid analgesics, acetaminophen, or NSAIDs. AMO was separately assessed with medications used only for migraine and adding those for other indications. PwM with AMO and without AMO were compared using survey weights to represent the adult population.

Results Among over 14 million PwM represented by the survey, 32.7% reported AMO of migraine-specific medications. Adding medication use for other conditions, AMO prevalence was 51.9%. Over two-thirds (67.4%) met the first AMO criterion with a cumulative mean of 27.0±29.2 days and 49.6% met the second criterion with 28.2±15.0 cumulative days. PwM with versus without AMO reported higher use of triptans (45.1% vs. 39.1%), combination analgesics (42.7% vs. 18.8%), NSAIDs (38.6% vs. 20.9%), and opioids (36.7% vs. 16.0%). PwM with AMO reported 8.7±8.0 days of triptan use, 13.1±9.2 days of combination analgesics, 13.3±9.1 days of NSAIDs, and 11.8±9.8 days of opioids. People with AMO had higher migraine burden, lower quality of life, lower productivity, higher depression severity, and higher healthcare resource utilization compared to those without.

Conclusions AMO is common in PwM. Treatments not associated with MOH are needed in this patient population.

Authors/Disclosures
Jessica Cirillo (Pfizer) PRESENTER	Mrs. Cirillo has received personal compensation for serving as an employee of Pfizer. Mrs. Cirillo has stock in Pfizer.
Motomori Lewis (Pfizer)	Motomori Lewis has received personal compensation for serving as an employee of Pfizer.
Joshua Brown, PhD (Pfizer, Inc.)	Dr. Brown has received personal compensation for serving as an employee of Pfizer, Inc..
Aaron Jenkins	Aaron Jenkins has received personal compensation for serving as an employee of Pfizer Ltd. Aaron Jenkins has stock in Pfizer Ltd.
Karin Hygge Blakeman	Karin Hygge Blakeman has received personal compensation for serving as an employee of Pfizer. Karin Hygge Blakeman has stock in Pfizer.
Jerry Yang (Pfizer Inc.)	Jerry Yang has received personal compensation for serving as an employee of Pfizer Inc. Jerry Yang has stock in Pfizer Inc.
Lucy Abraham (Pfizer R&D UK Ltd)	Lucy Abraham has received personal compensation for serving as an employee of Pfizer R&D UK Ltd. Lucy Abraham has stock in Pfizer R&D UK Ltd.
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.

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