Migraine is a common neurological disorder that affects both children and adults in the United States. It is a known cause of significant disability, ranked sixth by the World Health Organization for years lost to disability.

This year, at the Annual Scientific Meeting of the American Headache Society (AHS), several abstracts were presented that discussed the epidemiology and treatment patterns of migraine in the United States. These studies highlighted the discrepancy between the high prevalence of migraine and the use of non-specific medications to treat acute migraine attacks in the outpatient, emergency, and hospital settings.

Several studies presented at the AHS Annual Scientific Meeting highlight that migraine continues to be treated with non-specific acute medications. Opioids were the most commonly prescribed medication for acute migraine. The majority of persons with migraine (63.7%) used over-the-counter drugs.

Use of non-specific medications for migraine continues in patients who are admitted to the hospital. At the AHS Annual Scientific Meeting, Katherina Platzbecker highlighted the readmission rates in patients with migraine. Those who were admitted for unrelated surgery and treated for migraine during their inpatient stay were more likely to receive non-specific acute therapies. If given migraine-specific treatment, these patients were less likely to be re-admitted for any cause.

Epidemiology studies are useful to clinicians when treating patients because they highlight diagnosis and prescribing patterns, common trends within a disease, and unmet needs. For migraine, these studies all highlight that further education targeting primary care, hospitalists, and emergency physicians are needed to improve the quality of care provided to persons with migraine and help reduce the burden of opioid use. Opioids are well known to worsen migraine frequency and severity, causing opioid hyperalgesia and potentially contributing to central sensitization, both risk factors for transformation of migraine to chronic migraine. Targeted education on early diagnosis of migraine and appropriate acute treatment options for both outpatient and inpatient use may help reduce disability related to migraine.

 

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Neurology Times