Geographic variation in the use of triptans and opioids for the acute treatment of migraine attacks

Objective To assess the geographic variations in triptan and opioid prescribing patterns for patients with migraine. Background Numerous guidelines recommend triptans as the standard of care for migraine attacks, yet opioids are still widely used for migraine treatment. Variation in the use of opioi...

Full description

Saved in:
Bibliographic Details
Published in:Headache 2021-11, Vol.61 (10), p.1499-1510
Main Authors: Lee, Jae Hyun, Shewale, Anand R., Barthold, Douglas, Devine, Beth
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - therapeutic use
Census
Cohort Studies
Female
geographic variation
Geographical locations
Geographical variations
Geography
Headache
Humans
Male
Middle Aged
Migraine
Migraine Disorders - drug therapy
Narcotics
opioid
Opioids
Patients
Population studies
Practice Patterns, Physicians' - statistics & numerical data
prescribing patterns
Retrospective Studies
triptan
Tryptamines - therapeutic use
United States
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To assess the geographic variations in triptan and opioid prescribing patterns for patients with migraine. Background Numerous guidelines recommend triptans as the standard of care for migraine attacks, yet opioids are still widely used for migraine treatment. Variation in the use of opioids and triptans for the treatment of migraine by geographic location is not well known. Methods Using a US claims database, we conducted a retrospective cohort study of adults diagnosed with migraine between 2016 and 2018. We used a 12‐month follow‐up period to assess triptan and opioid utilization, stratified by the nine Census Bureau‐designated divisions. To examine the geographic factors that affect triptan and opioid use among patients, we conducted two sets of multivariable analyses. First, we analyzed the odds of a patient being a triptan or opioid user in the follow‐up period, defined as ≥1 triptan or opioid claim. We then analyzed the medication use rate among triptan or opioid users. Results Overall, we had a final study population of 113,921 patients. In the follow‐up period, 52.9% (60,247/113,921) [range: 48.0%–56.3%] of patients were triptan users and 41.0% (46,708/113,921) [range: 28.9%–48.4%] of patients were opioid users with significant differences across census divisions (p 
ISSN:0017-8748
1526-4610
DOI:10.1111/head.14238