The use of triptans and other acute treatments for the management of migraine in routine clinical practice in England: a retrospective cohort study using the Clinical Practice Research Datalink (CPRD)
Abstract
Migraine is a common and disabling neurological condition affecting around 10 million people in the UK. Optimal management has been indicated as a priority for improving migraine care in the UK, supported by clinical guidelines to provide clinicians with pathways for using acute and preventative treatments. There is a paucity of evidence on the real-world management of migraine, particularly with acute treatments. A retrospective cohort study using linked primary and secondary healthcare data in England (Clinical Practice Research Datalink [CPRD] Aurum and Hospital Episode Statistics [HES]). Adults with their first diagnosis of migraine between 1st January 2017 and 31st March 2019 were identified. Acute treatment patterns (prescribing rates, sequencing) and triptan use were described during a variable 12-month minimum follow-up period, up to 31st March 2020. A total of 62,205 patients met all eligibility criteria, of which 76.2% (n = 47,420) were female and the mean (SD) age at index was 39.8 (15.5) years. Almost 60% (n = 36,849; 59.2%) of the cohort received no prescription for acute treatment during follow-up, 23.1% (n = 14, 379) received acute treatment only and 17.6% (n = 10,977) received acute and preventative treatments. Triptans (25.7%; n = 15,971) and non-steroidal anti-inflammatory drugs (15.1%; n = 9,368) were the most frequently prescribed acute treatments during follow-up. Opioids were prescribed to 28.5% (n = 3,130) of the acute and preventative subgroup, and…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 62,205 participants or records.
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