Pharmacological Management of Migraine by Primary Care Providers in Nova Scotia

In Canada, the management of migraine is commonly carried out by primary care providers. Guidelines for the acute and preventative management of migraine in Canada are published by the Canadian Headache Society (CHS). There are currently limited data describing prescribing patterns among clinicians caring for patients with migraine in Canada.

Our aim for this exploratory study was to characterize the current pharmacological treatments prescribed for patients with migraine in Nova Scotia, Canada, seeking care through their primary care providers.

We conducted a retrospective cross-sectional analysis of deidentified electronic medical record (EMR) data collected from January 2019 to December 2023 from the Maritime Research Network for Family Practice (MaRNet-FP) to identify prescribing patterns for the acute and preventative management of migraine in Nova Scotia.

In total, 3075 active patients who received a diagnosis of migraine were identified in the MaRNet-FP EMR database (6.53% of total patients). Migraine patients were predominantly female (81%) with an average age of 44 ± 16 years. Between 2019 and 2023, 50% of patients with a migraine diagnosis received a prescription for a medication that can be used for the acute management of migraine, most commonly, nonsteroidal anti-inflammatory drugs and triptans. Over the same period, 60.4% of patients were prescribed a medication that can be used for the prevention of migraine, the most common of which were anti-depressants and beta-blockers.

Our findings demonstrate alignment with CHS guidelines but highlight potential undertreatment of migraine.