[Triptan treatment in migraine: a dose-based model for persistence and acute medication use patterns using nationwide...

Nationwide data on real-world medication use patterns in the treatment of migraine attacks are limited. Health insurance databases provide an opportunity for dose-based and comparable analyses of medication utilization.

Using a nationwide health insurance database, we examined patterns of pharmacological treatment of migraine attacks, persistence of triptan therapy, and temporal changes in dose-based categories of acute medication use.

A retrospective longitudinal study was conducted using the nationwide prescription database of the National Health Insurance Fund Administration of Hungary. A total of 7840 patients without prior triptan use were included. Medication utilization was assessed in three-month intervals. Acute medication use categories were defined based on the amount of dispensed migraine-specific agents and non-steroidal anti-inflammatory drugs. Treatment discontinuation was defined as a prescription refill gap exceeding 90 days.

During the first three months following triptan initiation, 36.7% of patients were classified into the medication overuse pattern category, while 49.4% showed low analgesic use. During follow-up, approximately 70% of patients had no further prescription fills for acute medications. The initially high rate of medication overuse patterns decreased over time; however, it remained persistently present in 16-18% of patients. Among patients who initially used a higher proportion of triptans relative to non-specific analgesics, subsequent medication overuse patterns occurred less frequently. Persistence of triptan therapy declined rapidly: 14.4% of patients still filled triptan prescriptions at 90 days, while 5.3% continued to do so after one year.

Dose-based categorization may be suitable for population-level assessment of acute migraine-related medication use patterns. The model may contribute to the structured characterization of medication burden and to monitoring medication utilization in migraine care. Orv Hetil. 2026; 167(34): 1343-1352.