Triptans for Acute Migraine Headache: Current Experience With Triptan Use and Prescription Habits in a Tertiary Care Headache Outpatient Clinic: An Observational Study

BackgroundTriptans are recommended as first-line therapy in the acute phase of a migraine attack. We describe patterns of triptan use in a tertiary care headache outpatient clinic, particularly addressing factors that are associated with triptan discontinuation. MethodsFrom December 2009 until August 2012, demographic and clinical data of consecutive patients with migraine were collected. The Headache Impact Test (HIT-6) was used to measure the adverse impact of headaches. Factors associated with triptan discontinuation were analyzed using binary logistic regression. ResultsOf 511 migraine patients included, 73.2% (n=374) were triptan naive on first consultation. At follow-up, 57.1% of new triptan users (n=72/126) reported pain-freedom or pain relief after 2 hours, 40.5% (n=51/126) did not refill their triptan, another 15.1% (n=19/126) switched to a different type of triptan. Negative response to triptan treatment and substantial or severe headache impact (HIT-6 score 56) at first follow-up were associated with triptan discontinuation (OR 0.39 [95% CI 0.200.78], P=.007; OR 3.33 [95% CI 1.10-10.03], P=.033). ConclusionsAlthough triptans have been in clinical use for more than two decades, many migraine sufferers in our study population were found to be triptan naive on first consultation. The HIT-6 score may be used as an indicator of triptan adherence and help to identify patients at risk for triptan discontinuation.