More than half of patients with chronic migraine receive opioids

Opioids were prescribed to more than half of patients with chronic migraine and about one-third of patients with episodic migraine, according to findings presented at the American Academy of Neurology annual meeting.

“Chronic migraine remains suboptimally treated,” Jelena M. Pavlovic, MD, PhD, of Montefiore Medical Center, and colleagues wrote. “Opioids have been used for acute treatment, but are not recommended for regular use.”

Pavlovic and colleagues conducted a study to determine the patterns of opioid use in patients with chronic migraine and episodic migraine. The researchers enrolled 192 patients aged 18 years or older who were diagnosed with chronic migraine (n = 129; mean age, 49.4 years; 93.8% women) or episodic migraine (n = 63; mean age, 48.8 years; 82.5% women).

Results showed that 67.4% of patients with chronic migraine had one or more prescriptions for acute and preventive medications, as did 55.6% of patients with episodic migraine. One or more prescriptions for opioids were filled by 53.5% of patients with chronic migraine and 36.5% of patients with episodic migraines.

Patients with chronic migraine had a mean of four opioid prescriptions, while those with episodic migraine had 2.8. Three or more opioid prescriptions were filled by 33.3% of patients with chronic migraine and 15.9% of patients with episodic migraine.

A diagnostic code for pain was given to 13.2% of patients with chronic migraine and 7.9% of patients with episodic migraine.

“Treatment patterns, including opioid use, particularly in [chronic migraine] patients indicate opportunities for better management,” Pavlovic and colleagues concluded. – by Alaina Tedesco

Reference:

Pavlovic JM, et al. Migraine treatment patterns and opioid use among chronic and episodic migraine patients identified by a clinician-administered semi-structured diagnostic interview. Presented at: American Academy of Neurology Annual Meeting. April 21-27, 2018; Los Angeles.

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