Abstract
BackgroundThe persistence of triptan use among newly prescribed users is low in the United States and European countries. However, triptan refill patterns in Asian primary care practices have not been well described.MethodsData from the National Health Insurance Research Database in Taiwan were used to conduct a retrospective cohort analysis from 2005 to 2008. All participants were followed for 2 years after receiving a new triptan prescription. Refill and 2-year retention rates of newly prescribed triptans were calculated, and predictors of the first triptan refill and 2-year retention were analyzed.ResultsOf the 13,951 participants with a new triptan prescription (99.9% sumatriptan), 67.4% were prescribed by a neurologist, 67.4% were prescribed at least one prophylactic agent for migraine. Of them, 34.3% adhered to the newly prescribed triptan at the first refill, 0.01% switched to another triptan, and 40.9% switched to a non-triptan acute migraine medication. The 2-year retention rate was 4.0%. The frequency of headache-related neurologic visits for 1 year before the index date, first prescription of triptan or other acute medications, first triptan prescription by a neurologist, and prophylactic use were associated with higher first refill rates. The frequency of headache-related neurologic visits 1 year before the index date and first triptan prescription by a neurologist were related to higher 2-year retention rates. Diabetes mellitus and first triptan prescription at a local medical clinic were associated with reduced probability of continued triptan use at the first refill and 2 years.ConclusionsSimilar to Western societies, the refill and 2-year retention rates were low in new users of triptans. Frequency of neurologic visits and triptan prescription by a neurologist were significant predictors of adherence.
Highlights
The persistence of triptan use among newly prescribed users is low in the United States and European countries
Since 1995, Taiwan’s National Health Insurance (NHI) program has integrated all of the public insurance systems into a single-payer program that provides comprehensive healthcare to nearly 99% of the population in Taiwan
We identified all migraine patients who were newly prescribed with triptans between 2005 and 2008
Summary
The persistence of triptan use among newly prescribed users is low in the United States and European countries. Triptan refill patterns in Asian primary care practices have not been well described. Because many cases of migraine are chronic and intermittent, it is recommended. It is difficult to predict individual response to a specific agent or dose [5]. In the primary care setting, different panels and guidelines recommend various medications [6-9]. Nonspecific treatments are those effective for any pain disorder and include non-steroidal anti-inflammatory drugs (NSAIDs), combination analgesics, opioids, neuroleptics/ antiemetics, and corticosteroids. Specific therapies, such as ergotamine-containing compounds, dihydroergotamine, and triptans, are effective only for migraine
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