Prescribing pattern and quality of life in patients with migraine at a tertiary care teaching hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20252376Keywords:
Migraine, Quality of life, MIDAS, MIBS-4, Prescription patternAbstract
Background: Migraine, a prevalent and disabling neurological disorder, affects over a billion people globally, with a significant impact in India. Despite effective treatments, poor adherence and limited data on drug use and quality of life persist, especially in developing nations. Understanding these patterns is crucial for enhancing patient care, optimizing healthcare resources, and reducing the socioeconomic burden of migraine.
Methods: This one-year prospective observational study was conducted at Shree Krishna Hospital, Gujarat, following ethical clearance. A total of 150 migraine patients diagnosed according to the ICHD-3 (International Classification of Headache Disorders, 3rd Edition) were enrolled. Data on demographics, treatment, and quality of life (via MIDAS [Migraine Disability Assessment] and MIBS-4 [Migraine Interictal Burden Scale]) were collected. Statistical analysis was conducted using STATA 14.2. Informed consent ensured participant confidentiality and adherence to research standards.
Results: Among 150 migraine patients (74.7% female), most had low-frequency episodic migraine with moderate throbbing pain. NSAIDs (mainly naproxen) and TCAs (mainly amitriptyline) were widely used. MIDAS showed 11.3% had severe disability; MIBS-4 revealed 24% experienced severe interictal burden. Sleep disturbance, stress, and anxiety were common triggers, highlighting migraine's multifactorial impact on daily routine affecting quality of life.
Conclusions: Although triptans have proven efficacy as acute treatment, their utilization remains limited. Quality of life assessments using MIDAS and MIBS-4 revealed significant disability, underscoring the need for enhanced management strategies targeting associated psychological conditions such as anxiety and depression. Optimizing prescription practices, improving patient education, and incorporating lifestyle modifications are crucial for effective long-term migraine management. These interventions promise improved patient outcomes.
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Jena SS, Jena M, Dash M, Mishra S, Behera IC. Migraine: Pattern of Prescription & Adverse Drug Reaction Profile in A Tertiary Care Teaching Hospital. J Pharm Sci Res. 2015;7(3):111.
Lim JH, Karimi L, Wijeratne T. An evaluation of medication prescribing patterns for acute migraine in the emergency department: a scoping review. J Clin Med. 2021;10(6):1191. DOI: https://doi.org/10.3390/jcm10061191
Singh G, Sharma M, Kumar GA, Rao NG, Prasad K, Mathur P, et al. The burden of neurological disorders across the states of India: the Global Burden of Disease Study 1990-2019. Lancet Glob Heal. 2021;9(8):e1129-44.
Rimmele F, Müller B, Becker-Hingst N, Wegener S, Rimmele S, Kropp P, et al. Medication adherence in patients with cluster headache and migraine: an online survey. Sci Rep. 2023;13(1):4546. DOI: https://doi.org/10.1038/s41598-023-30854-y
Amiri P, Kazeminasab S, Nejadghaderi SA, Mohammadinasab R, Pourfathi H, Araj-Khodaei M, et al. Migraine: a review on its history, global epidemiology, risk factors, and comorbidities. Front Neurol. 2022;12:800605. DOI: https://doi.org/10.3389/fneur.2021.800605
Rawat M, Joshi P, Joshi H, Shah K, Malhotra S. Drug utilization and Quality of Life in patients of Migraine at a Tertiary Care Hospital in India. Int J Current Res. 2018;10(08):72853-8.
Roessler T, Zschocke J, Roehrig A, Friedrichs M, Friedel H, Katsarava Z. Administrative prevalence and incidence, characteristics and prescription patterns of patients with migraine in Germany: a retrospective claims data analysis. J Headache Pain. 2020;21(1):85. DOI: https://doi.org/10.1186/s10194-020-01154-x
Takizawa T, Kitano T, Iijima M, Togo K, Yonemoto N. Treatment patterns and characteristics of patients with migraine: results from a retrospective database study in Japan. J Headache Pain. 2024;25(1):19. DOI: https://doi.org/10.1186/s10194-024-01722-5
Sumelahti ML, Mattila K, Sillanmäki L, Sumanen M. Prescription patterns in preventive and abortive migraine medication. Cephalalgia. 2011;31(16):1659-63. DOI: https://doi.org/10.1177/0333102411427602
Schuurmans A, Van Weel C. Pharmacologic treatment of migraine. Comparison of guidelines. Can Fam physician. 2005;51(6):838-43.
Nicolas S, Nicolas D. Triptans. In: StatPearls. StatPearls Publishing; 2024.
Kalra AA, Elliott D. Acute migraine: Current treatment and emerging therapies. Ther Clin Risk Manag. 2007;3(3):449-59.
Ramsey RR, Ryan JL, Hershey AD, Powers SW, Aylward BS, Hommel KA. Treatment adherence in patients with headache: A systematic review. Headache. 2014;54(5):795-816. DOI: https://doi.org/10.1111/head.12353
Gurunath S, Praneeth MG, Shireesha MJ. A cross sectional study to assess the prescription pattern, clinical characteristics and quality of life in migraine patient in tertiary care teaching hospital. Mater Sci. 2019;18(02).
Bhide S, Verma P, Ravat S, Phirke C, Rao S. A study of drug prescription patterns, disease-therapy awareness and of quality of life among patients with migraine visiting a tertiary care hospital in Mumbai, India. Int J Basic Clin Pharmacol. 2023;12(6):855-60. DOI: https://doi.org/10.18203/2319-2003.ijbcp20233198
Soni G, Jain S, Rathi P, Goswami P. Current trends in prescribing pattern of anti-migraine drugs in patients of migraine at a tertiary care teaching hospital. Int J Med Med Res. 2021;7(2):5-14. DOI: https://doi.org/10.11603/ijmmr.2413-6077.2021.2.12636
Xu J, Kong F, Buse DC. Predictors of episodic migraine transformation to chronic migraine: a systematic review and meta-analysis of observational cohort studies. Cephalalgia. 2020;40(5):503-16. DOI: https://doi.org/10.1177/0333102419883355
Zebenholzer K, Andree C, Lechner A, Broessner G, Lampl C, Luthringshausen G, et al. Prevalence, management and burden of episodic and chronic headaches—a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain. 2015;16:1-9. DOI: https://doi.org/10.1186/s10194-015-0531-7
Kelman L. Migraine pain location: a tertiary care study of 1283 migraineurs. Headache J Head Face Pain. 2005;45(8):1038-47. DOI: https://doi.org/10.1111/j.1526-4610.2005.05185.x
Chakravarty A, Mukherjee A, Roy D. Migraine pain location in adult patients from eastern India. Ann Indian Acad Neurol. 2008;11(2):98-102. DOI: https://doi.org/10.4103/0972-2327.41876
Khaskheli MA, Chand L, Saifullah SA. Identification of the Location of Migraine Pain in an Adult Population of a Tertiary Care Hospital: A Cross-Sectional Study. Int J Cur Res Rev| Vol. 2022;14(09):69. DOI: https://doi.org/10.31782/IJCRR.2022.14912
Minen MT, De Dhaem OB, Van Diest AK, Powers S, Schwedt TJ, Lipton R, et al. Migraine and its psychiatric comorbidities. J Neurol Neurosurg Psychiatry. 2016;87(7):741-9. DOI: https://doi.org/10.1136/jnnp-2015-312233
Jevdokimov D, Agejeva N, Smeltere L. Most common psychiatric disorders as migraine comorbidities. J Pharm Pharmacol. 2020;8:220-1. DOI: https://doi.org/10.17265/2328-2150/2020.07.004
Olesen J, Bes A, Kunkel R, Lance JW, Nappi G, Pfaffenrath V, et al. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. DOI: https://doi.org/10.1177/0333102413485658
Irfan S, Mohammed F, Hameed S, Ravi V, Kashish V, Srimati S, et al. The Assessment of Clinical Characteristics, Treatment Patterns, and Burden of Illness in Patients With Episodic and Chronic Migraine: A Cross-Sectional Study. Cureus. 2024;16(4). DOI: https://doi.org/10.7759/cureus.59073
Kandasamy G, Almaghaslah D, Almanasef M, Almeleebia TM, Orayj K, Siddiqua A, et al. A study of the effect of treatment on the clinical profile, pain, and disability in migraine patients seen in a tertiary hospital. J Multidiscip Healthc. 2024;3525-34. DOI: https://doi.org/10.2147/JMDH.S471216
Shapiro RE, Martin AA, Bhardwaj S, Thomson H, Maculaitis MC, Anderson C, et al. Relationships between headache frequency, disability, and disability-related unemployment among adults with migraine. J Manag Care Spec Pharm. 2023;29(2):197-209. DOI: https://doi.org/10.18553/jmcp.2023.29.2.197
Awaki E, Takeshima T, Matsumori Y, Hirata K, Miyazaki N, Takemura R, et al. Impact of Migraine on Daily Life: Results of the Observational survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study. Neurol Ther. 2024;13(1):165-82. DOI: https://doi.org/10.1007/s40120-023-00569-3
Hadia R, Kapadi V, Parekh K, Naidu S, Prakash S, Chandrakar V, et al. A Cross Sectional Observational Study to Assess Clinical Characteristics, Prescription Pattern and Health Related Quality of Life in Migraine Patients at Tertiary Care Teaching Hospital. J Young Pharm. 2022;14(3). DOI: https://doi.org/10.5530/jyp.2022.14.62
Ashina S, Muenzel EJ, Nicholson RA, Zagar AJ, Buse DC, Reed ML, et al. Machine learning identifies factors most associated with seeking medical care for migraine: Results of the OVERCOME (US) study. Headache J Head Face Pain. 2024. DOI: https://doi.org/10.1111/head.14729
Pascual J, Núñez M, Panni T, Díaz-Cerezo S, Novick D, Ciudad A. Burden and Unmet needs in Migraine patients: results from the OVERCOME (Spain) Study. Pain Ther. 2023;12(5):1209-20. DOI: https://doi.org/10.1007/s40122-023-00538-6
Hubig LT, Smith T, Williams E, Powell L, Johnston K, Harris L, L'Italien G, Coric V, Lloyd AJ, Lo SH. Measuring interictal burden among people affected by migraine: a descriptive survey study. J Headache Pain. 2022;23(1):97. DOI: https://doi.org/10.1186/s10194-022-01467-z
Buse DC, Rupnow MFT, Lipton RB. Assessing and managing all aspects of migraine: Migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. In: Mayo Clinic Proceedings. Elsevier; 2009: 422-435. DOI: https://doi.org/10.4065/84.5.422
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