Women With Obesity Undertreating Migraine Pain

New study uses smartphone technology to evaluate real-time individual medication patterns and discover unmet treatment needs

SAN DIEGO, CA (June 9, 2016) – According to a new study presented this week at the 58th Annual Scientific Meeting of the American Headache Society, on average 43% of headaches in women with migraine and obesity go untreated, contradicting the common misconception that migraine sufferers overuse medications.

The objective of the study, led by Jelena Pavlovic, MD, PhD, was to understand acute medication (AM) use patterns for optimization of migraine treatment. Using innovative smartphone-based Ecological Momentary Assessment (EMA), the study evaluated AM use patterns on a per headache basis over 28 consecutive days in women with migraine and obesity via a smartphone diary. AMs were divided into two classes: 1) Non-migraine specific (i.e. NSAIDs [i.e. Aspirin, Ibuprofen, Naproxen], Excedrin, and other [i.e. Opioids and Bultalbital]) and 2) Migraine-specific (i.e. Triptans).

The data were then analyzed to identify the: percentage of participants using AMs, number of headache days experienced by users of different AMs, and percentage of headache days on which each of the different AMs were used.  Additionally, the percentage of participants who used each AM independently along with the most frequently used AM combinations were also calculated.

“Previous studies have examined acute medication use patterns, but most are limited to retrospective measures and incur associated problems such as recall bias and limited ecological validity,” said Dale Bond, PhD, Principal Investigator of the Women’s Health and Migraine (WHAM) randomized controlled trial, the study funded by the National Institute of Neurological Disorders and Stroke that provided the data for Dr. Pavlovic’s analysis.  WHAM is designed to test behavioral weight loss as a treatment for migraine in women with obesity. “Using EMA in this sample of women with obesity enabled us to obtain more detailed and richer data to understand how patients use AMs on a per-headache basis.

Findings reported that a substantial portion of headaches in women with migraine and obesity go untreated, and of the different AMs, NSAIDs were most frequently used as monotherapy, although the majority of participants used more than one medication class to treat their headaches across the 28-day period. Headache frequency was highest in those who used Bultalbital and opioids in addition to other AMs.

“There is a long-held misconception that high frequency migraine sufferers overuse medications, but we’ve found that women with migraines and obesity in our sample actually don’t take acute medication as frequently,” said Dr. Pavlovic. “Moreover, the fact that nearly half the attacks go untreated likely indicates significant unmet treatment needs.”

The study was presented at the 58th Annual Scientific Meeting of the American Headache Society in San Diego. The meeting draws about 1,000 headache and migraine researchers and treatment specialists from around the world to hear the latest scientific and clinical information on headache and migraine. This year’s program, “Take a Closer Look…At Migraine is four days of scientific presentations on the latest and most up-to date research in all aspects of migraine and related disorders.

The American Headache Society (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders. Educating physicians, health professionals and the public and encouraging scientific research are the primary functions of this organization. AHS activities include an annual scientific meeting, a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, and publication of the journal Headache. (www.americanheadachesociety.org)

The American Migraine Foundation is a non-profit foundation supported by the American Headache Society and generous donors dedicated to the advancement of migraine research. Its mission is to support innovative research and education that will lead to improvement in the lives of those who suffer from migraine and other disabling headaches. Information about migraine and related disorders can be found at www.americanmigrainefoundation.org

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