Migraine Treatment Patterns and Opioid Use Among Chronic and Episodic Migraine Patients Identified by a Clinician-Administered Semi-Structured Diagnostic Interview (S32.001)

Field: Medicine (Health Sciences)

Objective: To describe migraine treatment patterns and opioid use in chronic migraine (CM) and episodic migraine (EM) patients. Background: CM remains suboptimally treated. Opioids have been used for acute treatment, but are not recommended for regular use. Design/Methods: Eligible patients were enrolled in a large medical group, ≥18 years, had ≥12 months of continuous enrollment, and had ≥1 claim with a migraine diagnosis in the 12-month period from the screening date to 364 days prior to screening. A physician-administered Semi-Structured Diagnostic Interview, which included questions related to headache symptoms, frequency, disability, medication use, and diagnosis, was used to classify patients as CM or EM. Acute, preventive, and opioid treatment (in the prior 12 months) and baseline characteristics were assessed for CM and EM patients. Results: Of the 192 patients, 129 had CM and 63 had EM. The CM cohort had a mean age of 49.4 (SD=12.6) years and was 93.8% female. The EM cohort had a mean age of 48.9 (SD=15.4) years and was 82.5% female. 67.4% of CM patients and 55.6% of EM patients had ≥1 claim for both acute and preventive medications. 53.5% of CM patients and 36.5% of EM patients had ≥1 opioid claim ( P Conclusions: Approximately two-thirds of CM patients filled prescriptions for both acute and preventive medications in the past year. Over half of CM patients and about a third of EM patients received an opioid prescription in the same time period. Treatment patterns, including opioid use, particularly in CM patients indicate opportunities for better management. Study Supported by: Allergan plc Disclosure: Dr. Pavlovic has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc and the American Headache Society. Dr. Yu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc employee. Dr. Yu holds stock and/or stock options in Allergan plc, which sponsored research in which Dr. Yu was involved as an investigator. Dr. Yu holds stock and/or stock options in Allergan plc. Dr. Silberstein has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Receives honoraria from Alder Biopharmaceuticals; Allergan, Inc.; Amgen; Avanir Pharmaceuticals, Inc.; eNeura; ElectroCore Medical, LLC; Labrys Biologics; Medscape, LLC; Medtronic, Inc.; Neuralieve; NINDS; Pfizer, Inc.; and Teva Pharmaceuticals. Dr. Silberstein has received research support from His employer receives research support from Allergan, Inc.; Amgen; Cumberland Pharmaceuticals, Inc.; ElectroCore Medical, Inc.; Labrys Biologics; Eli Lilly and Company; Merz Pharmaceuticals; and Troy Healthcare. Dr. Reed has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Vedanta Research. Dr. Reed holds stock and/or stock options in Vedanta Research, which sponsored research in which Dr. Reed was involved as an investigator. Dr. Reed has received research support from Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Dr. Reddy’s Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., Inc., and Novartis, via grants to the National Headache Foundation. Vedanta Research ha. Dr. Kawahara has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Has served as a consultant Allergan and is a full-time employee of the DaVita Medical Group. Dr. Cowan has nothing to disclose. Dr. Dabbous has nothing to disclose. Dr. Campbell has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc employee. Dr. Campbell holds stock and/or stock options in Allergan plc, which sponsored research in which Dr. Campbell was involved as an investigator. Dr. Campbell holds stock and/or stock options in Allergan plc. Dr. Pulicharam has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Hs served as a consultant and received consulting fees from DaVita Medical Group. Dr. Viswanathan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan plc. Dr. Viswanathan holds stock and/or stock options in Yes, Allergan plc, which sponsored research in which Dr. Viswanathan was involved as an investigator. Dr. Viswanathan holds stock and/or stock options in Yes, Allergan plc. Dr. Lipton has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Has reviewed for the NIA and NINDS, serves as consultant, advisory board member, or has received honoraria from: Alder, Allergan, Amgen, Autonomic Technologies, Avanir, Boston Scientific, Dr. Reddy’s, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmit. Dr. Lipton has received royalty, license fees, or contractual rights payments from Receives royalties from Wolff’s Headache, 8th Edition, Oxford University Press, 2009 and Informa. Dr. Lipton holds stock and/or stock options in Holds stock options in eNeura Therapeutics and Biohaven. Dr. Lipton has received research support from Support from the NIH, the Migraine Research Foundation, the National Headache Foundation, Allergan plc, Amgen, Dr Reddy’s, and Novartis.