Assessing Migraine: An Enquiry into Prophylactic Treatment Patterns by Diagnosis: The AMEND Study (P3.042)

Abstract

OBJECTIVE:To assess the prophylactic treatment patterns for migraine patients diagnosed and not diagnosed with chronic migraine (CM). BACKGROUND: Current prophylactic management of migraine includes a variety of concomitantly prescribed treatments. Existing research indicates migraine disorders may be underdiagnosed. DESIGN/METHODS: Retrospective medical records were reviewed for patients with CM and Non-CM headache diagnoses (NCT01946126). Qualifying medical records were required to have 蠅 2 visits during the 15-month period. Patients were required to have at least one visit with a minimum of 8 headache days per 30-day period. Prophylactic medication records were collected at the first visit (FV) and most recent visit (MRV). Evaluable headache day records were collected throughout the study. RESULTS: Medical records from 459 patients qualified and were analyzed. Of these patients, 40[percnt] had a diagnosis of CM, and 60[percnt] had a Non-CM diagnosis. Of the Non-CM patients, 96[percnt] had a migraine diagnosis, while 4[percnt] had other headache diagnoses. A majority of the Non-CM population (55[percnt]) reported at least one visit with 蠅 15 headache days. During the study period, 68 patients had a change in diagnosis to CM. Migraine prophylaxis increased overall by 17[percnt] from FV to MRV. Among patients who were maintained on onabotulinumtoxinA during both FV and MRV, other oral prophylactic use decreased by 12.3[percnt]. CONCLUSIONS: The majority of migraineurs without a diagnosis of CM reported 15 or more headache days per month suggesting a potential underdiagnosis of CM. Patients diagnosed with CM were more likely to receive onabotulinumtoxinA than those with 蠅 15 days of headache per month with no CM diagnosis. Patients who received onabotulinumtoxinA treatment at FV and MRV showed a decrease in the use of other prophylactics suggesting a potential benefit to onabotulinumtoxinA treatment. Accurate diagnosis of migraine is vital to optimize appropriate treatment regimens for patients with this debilitating disease.

Disclosure: Dr. Reddy has received research support from Allergan, Inc. Dr. Policastro has received personal compensation for activities with Allergan, Inc. Dr. Reppine has received personal compensation for activities with Allergan, Inc. as an employee. Dr. Sekab has received research support from Allergan, Inc. Dr. Purdy has received personal compensation for activities with AHRM, Inc. as an employee. Dr. Dalfonso has received personal compensation for activities with AHRM Inc. as an employee. Dr. Magar has received personal compensation for activities with AHRM Inc. as an employee.