Description of Prophylactic drug utilization Patterns in Migraine Patients

Abstract

A285claim date was designated as the index date. Continuous health plan enrollment 12 months pre-and post-index date was required. Patients were assigned to four monotherapy AED cohorts based on drug class: sodium channel blockers (SCs), gamma-aminobutyric acid analogs (GABAs), synaptic vesicle protein 2A binding (SV2) and multiple mechanisms (MMs). Adherence was assessed using the proportion of days covered (PDC) and persistence was defined as days to discontinuation with an allowable treatment gap of 45 days without the index AED. Logistic and Cox proportional hazards models were used to compare the results among the cohorts. RESULTS: Patients in the SC cohort had significantly lower baseline Charlson Comorbidity Index scores (1.82), indicating that they were healthier than those in the GAMA (2.08, p< 0.001) and SV2 (2.46, p< 0.001) cohorts. Patients in the SC cohort were significantly less likely to have a baseline psychiatric disorder (37.6%) than those in the GABA (63.8%, p< 0.001) and MM (52.1%, p< 0.001) cohorts. Patients treated with GABAs (OR= 0.44, p< 0.001) and MMs (OR= 0.63, p< 0.001) were significantly less likely to adhere to their medications (PDC < 80%) than those treated with SC. Furthermore, patients treated with GABAs (hazard ratio [HR]= 1.74; 95% confidence interval [CI]= 1.59-1.90) and MMs (HR= 1.18; 95% CI= 1.07-1.29) were more likely to discontinue treatment during the follow-up period compared to those in the SC cohort. CONCLUSIONS: Patients treated with Sodium channel blockers are more likely adhere to treatment and have lower discontinuation of AED monotherapy than those treated with GABAs and MMs. PND44 MeasuriNg aDhereNce aND outcoMe iN treatMeNt of MultiPle sclerosis iN the geisiNger cliNic

Cycling Through Migraine Preventive Treatments: Implications for All-Cause Total Direct Costs and Disease-Specific Costs

“…The inclusion criteria also required 12 months of pre-and post-index continuous medical and prescription enrollment. Consistent with other research and to increase specificity, 14 with Medicaid coverage were excluded due to the heterogeneity of the patient population and a notably different health services and reimbursement structure compared with commercial providers. Patients with human immunodeficiency virus infection or cancer from 1 year pre-index to 1 year post-index were also excluded to reduce heterogeneity.…”

Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic

“…30 Patient-reported surveys have also been used to assess migraine prophylactic drug adherence, paving the way for the identification of noncompliance risk factors. 35 In 2013, a World Health Organization (WHO) quality-of-life 26-question short form was used to compare 149 patients with epilepsy to 1,238 healthy English citizens, contributing valuable insights to psychosocial disease effects. 36 In fact, a series of studies have suggested that the WHO Disability Assessment Schedule 2.0 is useful for monitoring outcomes in a wide range of clinical and service settings.…”