Patterns and Predictors of Prescription Medication Use in the Management of Headache: Findings From the 2000 Medical Expenditure Panel Survey

Devine, Joshua W.; Farley, Joel F.; Hadsall, Ronald S.

doi:10.1111/j.1526-4610.2005.00240.x

Cited by 23 publications

(22 citation statements)

References 37 publications

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“…In reality, clinicians presently employ a gamut of medications for migraine therapy, some with firm evidence of efficacy, others lacking substantiation of positive effects [5,23].To promote improved use of drugs, the Consortium's guidelines rank acute medications. The highest ranking signifies that multiple randomized clinical trials, directly relevant to the recommendations, yield a consistent pattern of a statistically significant clinical benefit [22].…”

Section: Migraine Treatmentmentioning

confidence: 98%

“…Of note, studies examining prescribing patterns cite aspirin or acetaminophen combined with butalbital and caffeine as one of the most common, acute migraine drugs selected by US physicians [5,23,44]. Yet, not a single placebo-controlled, randomized trial has concluded that butalbital-combination products are more effective than placebo for migraine [22].…”

Section: Migraine Treatmentmentioning

confidence: 99%

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Optimizing migraine therapy: evidence-based and patient-centered care

Wenzel

Nissan

2006

Expert Review of Neurotherapeutics

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Migraine is a chronic, intermittently debilitating neurovascular condition that affects the physical, mental and social aspects of health-related quality of life. Primary care provider interactions with migraine sufferers are common, highlighting the need for clinicians to provide optimal therapy. A comprehensive therapy plan should encompass the whole patient, via a patient-physician partnership where goals and strategies are mutually established. Key treatments include nondrug approaches, such as education and lifestyle modifications, to reduce the occurrence of attacks, as well as acute medications to address the immediate need for relief during an attack. Routine assessment and adjustment of therapy based on data recorded by patient diaries is paramount. Clinical trials support the use of triptans and dihydroergotamine for moderate-to-severe migraine and nonsteroidal anti-inflammatory drugs (alone or in combination with antiemetics or caffeine) for mild-to-moderate migraine, as the treatments of choice to reduce pain and disability time in a cost-effective manner. Published evidence also endorses stratified care, where medication selection is geared towards disease severity, instead of step care, where nonspecific mediations are given to all patients. Thus, patients with significant migraine-induced debilitation, as assessed by tools, such as the Migraine Disability Assessment Scale or the Headache Impact Test, are prescribed migraine-specific agents from the onset of therapy, thereby avoiding the inherent failures of step care. For individuals experiencing a high frequency of attacks or routine debilitation, preventive medications are warranted.

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Section: Migraine Treatmentmentioning

confidence: 98%

Section: Migraine Treatmentmentioning

confidence: 99%

Optimizing migraine therapy: evidence-based and patient-centered care

Wenzel

Nissan

2006

Expert Review of Neurotherapeutics

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“…30 Furthermore, the use of butalbital-containing products and narcotics doubles the risk for episodic migraine to evolve into chronic daily headache. 31 In clinical practice, problems associated with use of butalbital-containing products are so rampant that some headache-specialist physicians have proposed banning butalbital-containing products. 32 Almost half of the survey's key informants recommend butalbital-containing products as a possible migraine treatment.…”

Section: Discussionmentioning

confidence: 99%

Didactic Migraine Education in US Doctor of Pharmacy Programs

Wenzel

Padiyara

Schommer

2010

American Journal of Pharmaceutical Education

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Objective. To compare didactic migraine education in doctor of pharmacy (PharmD) programs in the United States with the Headache Consortium's evidence-based migraine treatment recommendations. Methods. A self-administered survey instrument was mailed to all 90 Accreditation Council for Pharmacy Education (ACPE) approved PharmD programs in the United States. Results. Seventy-seven programs responded (86%) and 69 useable survey instruments were analyzed. Fifty-five percent of programs discussed the Consortium's guidelines, 49% discussed the selection of nonprescription versus prescription agents, 45% recommended a butalbital-containing product as migraine treatment, and 20% educated students about tools for assessing migraine-related debilitation. At least 50% of programs taught information consistent with the remaining Consortium recommendations.Conclusion. Approximately half of the PharmD programs teach concepts about migraine headache treatment consistent with the US Headache Consortium's recommendations.

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“…6 Despite advances in treatment, however, most patients with chronic headache continue to be undertreated or misdiagnosed. [7][8][9] Given that patients with chronic headache disorders utilize more health care resources and use more medication compared to patients with other diseases, 5,10 multiple authors have advocated the use of interdisciplinary care when managing these patients. 6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Several studies on the effect of interdisciplinary care in patients with headache have shown reduced frequency of headaches; reduced usage of attackaborting medication; reduced levels of depression, anxiety, and overall disability; and decreased absence rate from work.…”

Section: Introductionmentioning

confidence: 99%