Abstract

BackgroundTo evaluate triptan use and overuse as well as prescription patterns in Austria based on a nationwide healthcare database because data on triptan use and overuse in Austria is missing.MethodsWe included all persons insured with one of 19 Austrian social security institutions in 2007. Inclusion criteria comprised an age of 18–99 years, known sex, and receipt of insurance benefits. We defined triptan use as ≥1 package of a triptan dispensed in 2007 and triptan overuse as ≥30 defined daily doses dispensed in at least one quarter.ResultsOut of 8.295 million inhabitants in Austria, 7,426,412 persons (89.5%) were insured with a social insurance carrier and 5,918,487 persons of those insured (79.7%) fulfilled the inclusion criteria. Among the latter 33,062 persons (0,56%) were triptan users and 1970 (0.033%) were triptan overusers. The estimated proportion of persons with migraine using a triptan was less than 6%. Among users 5.9% were overusers of whom 55% overused triptans in ≥2 quarters of 2007. The median number of days of sick-leave was higher in triptan users than in non-users: due to any reason of sick-leave 12 vs. 10, p < 0.001, due to migraine 3 vs. 2, p < 0.001. The proportion of hospital admissions did not differ between triptan users and non-users.Conclusion The rate of triptan use is low in Austria but triptan users are at risk for triptan overuse. In triptan users more days of sick-leave and the same proportion of hospital admissions as in the older non-users suggest poorer health.

Highlights

  • To evaluate triptan use and overuse as well as prescription patterns in Austria based on a nationwide healthcare database because data on triptan use and overuse in Austria is missing

  • Triptan users were significantly younger than non-users and they were more often female (82% vs. 54%; p < 0.001)

  • Triptan users without overuse refilled a median of 12 defined daily doses (DDD) per year, whereas triptan overusers refilled a median of 102 DDD per year (p < 0.001)

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Summary

Introduction

To evaluate triptan use and overuse as well as prescription patterns in Austria based on a nationwide healthcare database because data on triptan use and overuse in Austria is missing. Annual direct and indirect costs per person caused by migraine were estimated at 1222 Euros rising to 3700 Euros in chronic migraine in 2008 and 2009 [3, 4]. These costs are largely due to sick leave and presenteeism [3]. Acute migraine attacks are the management of migraine requires considering comorbidities such as depression and anxiety disorders [8]. Their prevalence in patients with migraine was estimated two to 10 times that of the general population with higher rates in chronic migraine [8]. Persons using triptans together with serotonergic antidepressants or other serotonergic drugs may be at risk of a serotonin syndrome [13]

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