METHODS: In this nationwide, observational study, all individuals with a migraine-related prescription between 2010 and 2020 were identified using the Norwegian Prescription Database. The outcomes of interest were the incidence and 1-year prevalence of migraine medication users, as well as individuals with triptan overuse. Patterns of medication use were statistically compared between women and men adjusted for age, year of treatment start, comorbidities and county of residence calculating adjusted odds ratios (aOR) with 95% confidence intervals (CI).
RESULTS: We identified 327,904 migraine medication users. The incidence ranged from 0.39% to 0.46%, and the 1-year prevalence increased from 1.99% to 2.99%. Preventive use increased >50% during the study period. Preventives were significantly more often prescribed to women than to men (39.72% vs. 33.75%; aOR 1.41, 95% CI 1.38 to 1.44). Triptan overuse was significantly more common among women, but women with overuse were more often using preventives, as compared to men (56.64% vs 52.69%; aOR = 1.43, 95% CI 1.37 to 1.49).
CONCLUSIONS: The prevalence of medically treated migraine is low. Overuse of triptans is frequent, especially among women. Clinicians should be encouraged to try out different triptans, recognize triptan overuse, and prescribe preventives when indicated.
方法:在全国范围内,观察性研究,我们使用挪威处方数据库确定了2010年至2020年间所有接受偏头痛相关处方的患者.感兴趣的结果是偏头痛药物使用者的发病率和1年患病率,以及过度使用Triptan的个人。根据年龄调整,对女性和男性之间的药物使用模式进行了统计比较,治疗开始的年份,合并症和居住地县计算调整比值比(aOR)和95%置信区间(CI)。
结果:我们确定了327,904名偏头痛药物使用者。发病率从0.39%到0.46%,1年患病率从1.99%上升到2.99%。在研究期间预防性使用增加>50%。女性处方预防药物的频率明显高于男性(39.72%vs.33.75%;aOR1.41,95%CI1.38至1.44)。Triptan的过度使用在女性中更为常见,但是过度使用的女性更经常使用预防措施,与男性相比(56.64%vs52.69%;aOR=1.43,95%CI1.37至1.49)。
结论:药物治疗偏头痛的患病率较低。经常过度使用Triptans,尤其是女性。应该鼓励临床医生尝试不同的曲坦,认识到曲坦过度使用,并在指示时开出预防措施。