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Abstract Details

Adherence to Guidelines and Outcomes Among People with Migraine Receiving Preventive Medication
Headache
Headache Posters (7:00 AM-5:00 PM)
128

Adherence to preventive medication guidelines for drug choices has rarely been studied.

Assess adherence to guidelines among people taking preventive medications for migraine.

Data were pooled from the 2018 and 2019 cohorts of the ObserVational survey of the Epidemiology, tReatment, and Care Of MigrainE (OVERCOME) study, a web-based survey conducted in a representative US sample. Respondents with migraine were identified via a validated migraine diagnostic screener based on ICHD-3 criteria (94.6%) and/or a self-reported medical diagnosis of migraine (60.0%). Eligible individuals sought care and used at least one preventive treatment within the past 3 months (excluding calcitonin gene-related peptide [CGRP] targeted monoclonal antibodies). Preventive medications were classified as “recommended” or “not recommended” based on AAN and AHS guidelines. Descriptive results included demographics and a measure of headache-related disability (MIDAS).

Of the 41,925 respondents with migraine, 5528 (13.2%) sought care and took migraine preventive treatment eligible for this analysis. Mean (SD) age was 40.9 (13.5) years, 70.7% were female, and 78.8% had episodic migraine. Overall, 4387 (79.4%) were taking a recommended preventive medication. Respondents treated by specialists (neurologists/headache or pain specialists) accounted for 46.7% (n=2584) of all preventive users; of these, 83.8% took recommended preventives. Respondents treated in primary care and not by specialists accounted for 43.4% (n=2401) of all preventive users; 76.6% took recommended preventives. Respondents treated in other care locations (e.g., Emergency Departments/Retail Clinics) accounted for 9.8% of preventive users (n=543); 70.5% took recommended preventives. Use of recommended preventives was highest in respondents treated by specialists (p<0.001). MIDAS scores within the analyzed population indicated moderate disability in 21.7% and severe disability in 48.5%.

Most people with migraine taking preventive medication received guideline-recommended treatments, more commonly those treated by specialists. High levels of disability in patients on guideline-based treatments may indicate significant unmet treatment needs.

Authors/Disclosures
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)
PRESENTER
Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Katherine Selzler Katherine Selzler has received personal compensation for serving as an employee of Eli Lilly and Company. Katherine Selzler has received stock or an ownership interest from Eli Lilly and Company.
Robert A. Nicholson, PhD (Eli Lilly & Company) Dr. Nicholson has received personal compensation for serving as an employee of Eli Lilly & Company. Dr. Nicholson has stock in Eli Lilly & Company. Dr. Nicholson has received intellectual property interests from a discovery or technology relating to health care.
Dawn C. Buse, PhD (Dawn C. Buse, PhD) Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Collegium. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.
Michael L. Reed, PhD (Vedanta Research) The institution of Dr. Reed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Reed has received research support from Allergan. The institution of Dr. Reed has received research support from Dr Reddy's Labs/Promius. The institution of Dr. Reed has received research support from Allay Lamp. Dr. Reed has a non-compensated relationship as a Research Analyst with National Headache Foundation that is relevant to AAN interests or activities.
Sait Ashina, MD (Beth Israel Deaconess Medical Center, Harvard Medical School ) Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Ashina has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impel Neuropharma. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer.
Robert E. Shapiro, MD, PhD, FAAN (Larner College of Medicine, University of Vermont ) Dr. Shapiro has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Shapiro has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of New England. Dr. Shapiro has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for EEOC.
Shonda Foster Shonda Foster has received personal compensation for serving as an employee of Eli Lilly and Company. Shonda Foster has received stock or an ownership interest from Eli Lilly and Company.
Yongin Kim Yongin Kim has received personal compensation for serving as an employee of Eli Lilly and Company. Yongin Kim has received stock or an ownership interest from Eli Lilly and Company.
Bert B. Vargas, MD, FAAN (Eli Lilly and Company) Dr. Vargas has received personal compensation for serving as an employee of Lilly USA. Dr. Vargas has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for ElevateMed. Dr. Vargas has stock in Eli Lilly. An immediate family member of Dr. Vargas has stock in Pfizer. Dr. Vargas has received personal compensation in the range of $500-$4,999 for serving as a Unaffiliated Neurotrauma Consultant with National Football League. Dr. Vargas has received personal compensation in the range of $10,000-$49,999 for serving as a Neurotrauma Consultant with National Association for Stock Car Auto Racing.