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Published on: June 2, 2014
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The migraine signature study: Methods and baseline results
Alice R Pressman1, Dawn C Buse2, Alice S Jacobson1
1Center for Health Systems Research, Sutter Health, Walnut Creek, CA, USA.
Headache
|December 28, 2020
Summary
Patients with migraine receiving care from neurologists (N-M) had higher rates of comorbidities and received more acute and preventive medications than those receiving primary care (PC-M) only. Neurologists prescribed more opioids, triptans, and antidepressants.
Area of Science:
- Neurology
- Health Services Research
- Epidemiology
Background:
- Migraine is a prevalent condition leading individuals to seek care from primary care (PC) and neurology services.
- Limited data exists on patient demographics, care patterns, and utilization variations within integrated health systems.
Purpose of the Study:
- To characterize patients receiving migraine services within a large healthcare network.
- To describe care and utilization patterns among these patients.
Main Methods:
- Retrospective cohort study using electronic health record (EHR) data from 2013-2017.
- Identified 94,149 migraine patients and 1,248,763 controls.
- Categorized migraine patients into PC-M (primary care only) and N-M (neurology involvement) groups.
Main Results:
- Migraine patients exhibited higher rates of psychiatric, autoimmune, pain, respiratory, neurologic, and cerebrovascular comorbidities compared to controls.
- The N-M group had more preexisting migraines and higher proportions of comorbidities than the PC-M group.
- N-M patients received more acute (89.4% vs. 80.6%) and preventive (81.4% vs. 55.5%) migraine medications, with antidepressants being the most common preventive class.
Conclusions:
- Neurology-involved migraine patients utilized more acute and preventive medications, including higher opioid prescription rates.
- Migraine patients, particularly those seen by neurologists, experienced a greater burden of comorbidities.
- These findings suggest that patients seeing neurologists may have more severe or complex migraine disease, warranting comprehensive care strategies.
