Triptans: Low utilization and high turnover in the general population

Panconesi, Alessandro; Pavone, Eleonora; Franchini, Michela; Mennuti, Nedo; Bartolozzi, ML; Guidi, Leonello; Banfi, Roberto

doi:10.1111/j.1468-2982.2009.02001.x

Cited by 23 publications

(42 citation statements)

References 31 publications

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“…This observation was common in all the categories considered in this investigation. Our results largely overlap literature data concerning larger populations, reflecting a low rate of utilization and a high percentage of treatment discontinuation [10]. Triptans represent, according to international guidelines [4], the most specific and effective therapy for acute migraine attacks.…”

Section: Discussionsupporting

confidence: 64%

Triptan use among hospital workers affected by migraine

et al. 2015

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Triptans represent the most specific and effective treatment for migraine attacks. Nevertheless, in clinical practice, they are often underused. Hospital workers, in particular physicians, are expected to be more aware of the correct use of specific drugs, especially for a very common disease such as migraine. Aim of this study was to evaluate whether different hospital workers affected by migraine are able to correctly manage the most suitable therapy for their migraine attacks. During a 1-year period, we submitted hospital employees to a structured interview with a questionnaire to investigate the presence of headache and its characteristics. In particular, in the subpopulation of subjects affected by migraine, we took information regarding their usual treatment for the control of attacks. The type of drug and the category of the working activity were synthesized as two different ordinal variables. Difference in the distribution of the different drug categories was evaluated with Chi squared test. Statistics was performed with SPSS 13.0 for Windows systems. We enrolled 1250 consecutive subjects: 20.3 % of the population (254 patients) was affected by migraine. Triptans use was significantly lower than that of non-steroidal anti-inflammatory drugs. The distribution of the use of the drugs was significantly different (p < 0.0001) at Chi squared test. Among migraineur physicians, only 10.7 % used triptans. Even in this subgroup, we observed a significant difference (p < 0.0001) in the distribution of the use of the drugs at Chi squared test. Our findings show a reduced use of triptans among hospital workers. These data reflect the unsatisfactory dissemination of knowledge regarding the correct management of migraine attacks and the advantages of treatment with triptans. An incorrect therapeutic approach to migraine contributes to the risk of the most important complications, such as drugs abuse or illness chronicization. These findings suggest that an insufficient awareness of migraine-related therapeutic options also involves hospital workers, including physicians.

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Section: Discussionsupporting

confidence: 64%

Triptan use among hospital workers affected by migraine

et al. 2015

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“…An Israeli health maintenance organization (HMO) study of 1498 patients receiving new triptan prescriptions found that 56% of patients purchased triptans only once during the 6-18 month follow-up period (13). Several pharmacy claims analyses conducted across Europe show similar results, with single-time triptan fill rates of 38%-56% (11,(14)(15)(16). The utilization and retention of triptans has been examined in managed care settings in the USA as well (17,18).…”

Section: Introductionmentioning

confidence: 79%

Triptan persistency among newly initiated users in a pharmacy claims database

Katić

Rajagopalan²,

et al. 2010

Cephalalgia

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Migraine patients were more likely to discontinue their triptan after their index prescription than at any other time in their prescription refill history. The majority of patients did not persistently refill triptans, but filled prescriptions for non-specific migraine therapies such as opioids and non-steroidal anti-inflammatory drugs. Reasons for triptan discontinuation warrant further investigation.

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“…[9][10][11][12][13][14][15] The fact that patients who filled their triptan prescriptions only once showed a significant decrease in the rates of physician office visits and diagnostic imaging after their index triptan fill is potentially suggestive of misdiagnosis. If these patients truly suffered from migraines, one would expect their medical services utilization rates to continue increasing on a trajectory similar to or worse than that of patients who frequently switched their triptans The fact that triptans seemed less effective at reducing the utilization of other services and medications among patient who switched triptans frequently is logical if triptan switching is viewed as an indicator of ineffectiveness.…”

Section: Patient Characteristics and Follow-up Time Stratified By Trimentioning

confidence: 99%

“…Roughly 15% of triptan users will try a new triptan over 1 year of follow-up. 9,10 Patients have reported lack of efficacy or side effects as the most common reasons for nonadherence. 14 In addition to the challenges of adherence and persistence, opioid use among migraine patients has become an increasingly controversial issue.…”

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confidence: 99%

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Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

Messali

Owens²,

Bloudek³

et al. 2014

JMCP

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Migraine headaches are among the most common neurological disorders in the United States and other Western countries. Eighteen percent of women and 6% of men in the United States above the age of 12 suffer from migraines-roughly 23 million Americans.1 Migraine prevalence is highest among 35 to 45 year olds, Caucasian women, and lower-income households.2 These factors associated with migraine prevalence have been consistently described in research conducted in the United States, Canada, and several European countries. [3][4][5] The direct costs of migraine treatment have been estimated to exceed $1 billion each year. 1,6 About 60% of these direct costs are attributable to physician office visits, and another 30% can be attributed to prescription drug treatment. The remaining 10% consists of inpatient treatment and emergency room visits. As is the case with many chronic diseases, the indirect costs of migraine headaches far outweigh the direct costs. The attributable productivity losses to American employers have been estimated to be roughly $13 billion annually. 1,6 The majority of these productivity losses ($8 billion each year) are the result of migraine-related missed workdays.From a payer's perspective, an important aspect of the value of prescription medications lies in their potential to prevent more costly utilization of health care resources, such as emergency room visits and inpatient hospitalizations, by managing ABSTRACTBACkgRoUnd: 23 million Americans suffer from migraine headaches, incurring more than $1 billion in direct medical costs each year (with another $13 billion in indirect productivity losses). Triptans are the most common treatment of choice for these patients; however, adherence and persistence to triptans are poor. Partly due to poor adherence to therapy, the ability of triptans to reduce the utilization of other medical services and prescription drugs remains unclear.

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Triptans: Low utilization and high turnover in the general population

Cited by 23 publications

References 31 publications

Triptan use among hospital workers affected by migraine

Triptan use among hospital workers affected by migraine

Triptan persistency among newly initiated users in a pharmacy claims database

Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

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