Undertreatment of Migraine in the United States – A Population Based Study

Migraine is a debilitating chronic disease that affects approximately 36 million of the United States population. The objective of the study is to investigate the prevalence and patient’s socio demographic characteristics associated with under treatment of migraine in the US. ambulatory care settings. A retrospective population-based study was conducted by analyzing a national database from 2010 National Ambulatory Medical Care Survey (NAMCS). The NAMCS is a national probability sample survey conducted annually by the National Center for Health Statistics. All patient visits coded with a diagnosis of migraine were included in the study. A series of weighted descriptive analyses were used to estimate the prevalence of prescription medications recommended in the American Neurology Association latest practice guidelines on migraine. A multivariate logistic regression was conducted to predict the maximum likelihood of migraine pharmacotherapy associated with patient’s socio demographic characteristics. An estimated total of 5.45 million outpatient visits related to migraines occurred in the US. Only 3.08 million visits (56.48%) received at least one migraine prescription. Abortive drugs were prescribed much more than prophylaxis drugs (68.8% vs 31.2%). The results from logistic regression identified patient’s gender (OR=0.164, 95%CI: 0.034 – 0.790), race (OR=0.123, 95%CI: 0.029 – 0.520), and ethnicity (OR=0.075, 95%CI: 0.006 – 0.927) contribute significant impacts on the migraine treatment. The study revealed that under treatment of migraine is a significant problem in the US. Future studies are recommended to explore intervention and educational strategies to ensure physicians are well-informed evidence-based practice guidelines and provide timely and appropriate treatment for people with Migraine.