Fewer than one in three people with migraine took guideline-recommended prescription medication, data presented at the American Headache Society (AHS) annual scientific meeting showed.

About 28% of survey respondents with mild to severe migraine-related disability took acute migraine medication, according to online survey results in the OVERCOME study.

And only 15% of people who had 4 or more monthly migraine days and moderate to severe migraine-related disability received preventive treatment, reported Sait Ashina, MD, of Beth Israel Deaconess Medical Center in Boston, and Susan Hutchinson, MD, of Orange County Migraine and Headache Center in Irvine, California.

The findings are not surprising, said Stewart Tepper, MD, of the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire, who wasn’t involved with the study.

Even among people who had the most severe migraine-related disability, two-thirds didn’t get treatment, Tepper pointed out.

Part of the problem may be education, he noted. “We have been trying since the 1990s to educate providers about how to diagnose migraine,” Tepper told MedPage Today.

But battles with payers also play a role. “It’s very discouraging,” he said. “Providers have to jump through hoops and, even then, a lot of drugs are not covered.”

OVERCOME looked at a nationally representative sample of 21,143 people with episodic and chronic migraine who completed a web-based survey in the fall of 2018. While earlier studies of treatment barriers were conducted in healthcare environments, “OVERCOME gives a different view, a contemporary view of the migraine healthcare landscape,” Ashina said.

Respondents self-reported their migraine diagnosis by a healthcare professional (61% of sample) or fulfilled criteria on the American Migraine Study diagnostic screener using ICHD-3 (94% of sample).

In the entire study population, 12,212 people had at least mild migraine-related disability (a MIDAS score of 6 or higher) and were included in the acute migraine analysis. A total of 5,873 people reported moderate or severe migraine disability (a MIDAS score of 11 or higher) and 4 or more monthly headache days on average in the past 90 days and were included in the preventive analysis.

The questionnaire asked about three steps involved in migraine management: seeking care, receiving a diagnosis, and taking recommended medication.


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