Access to Triptans for Acute Episodic Migraine: A Qualitative Study.

Abstract:

OBJECTIVE:Our study aims to examine factors related to access of triptans among multiple stakeholder groups. BACKGROUND:Triptans are a cornerstone of pain management for the acute treatment of migraine, but actual utilization of triptans is lower than ideal. Initial and continued access to triptans may be an important clinical issue in the acute treatment of migraines, but factors affecting access at the patient, provider, and health-care system levels have not been comprehensively explored. METHODS:A qualitative study was conducted in Ontario, Canada, between August 2013 and January 2014. Three participant groups were recruited to the qualitative study: (1) migraineurs who have experience accessing triptans; (2) physicians, including primary care physicians (PCPs) and neurologists, who have prescribed triptans; and (3) pharmacists who have dispensed triptans. Qualitative data were collected through one-on-one, semi-structured telephone interviews. The framework approach was used for data collection and analysis. RESULTS:Data collected from 19 migraineurs, 6 physicians, and 8 pharmacists were included in the analysis. Study participants discussed various factors that facilitate or hinder access to triptans, which were synthesized into four themes that emerged at the patient, provider, and health-care systems levels: (1) awareness; (2) apathy; (3) advocacy; and (4) affordability. Across all participant groups, awareness of available treatments and coverage policies for those treatments were potential factors relating to timely drug provision. Participants describe apathy in terms of patients' health-seeking behaviors and physicians' lack of concern toward migraine, which were seen as factors that could delay diagnosis and provision of appropriate treatment. Patients engaging in self-advocacy enhanced their ability to seek timely and appropriate provision of triptans at the patient level. At the health-care provider level, pharmacists were identified by patients as advocates for receiving more effective treatments for their migraines; pharmacists also self-identified with the advocate role. The affordability of triptans was a key concern impacting access at the systems level, but coverage limitations (eg, quantity limits) were also described to influence the appropriateness of prescribed migraine treatment. CONCLUSION:This study fills a gap in knowledge about access to triptans and how this may be impacted by patient, provider, and health-care systems barriers. Overall, our study sheds light on the experiences of prescribing, dispensing, and accessing triptans for migraine treatment, and unveils important information that can impact how patients access these drugs.

journal_name

Headache

journal_title

Headache

authors

Khan S,Mascarenhas A,Moore JE,Knowles S,Gomes T

doi

10.1111/head.12593

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

199-211

eissn

0017-8748

issn

1526-4610

journal_volume

55 Suppl 4

pub_type

杂志文章

相关文献

HEADACHE文献大全
  • Posterior hypothalamic and brainstem activation in hemicrania continua.

    abstract:OBJECTIVE:To determine the brain structures involved in mediating the pain of hemicrania continua using positron emission tomography. BACKGROUND:Hemicrania continua is a strictly unilateral, continuous headache of moderate intensity, with superimposed exacerbations of severe intensity that are accompanied by trigemina...

    journal_title:Headache

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1526-4610.2004.04141.x

    authors: Matharu MS,Cohen AS,McGonigle DJ,Ward N,Frackowiak RS,Goadsby PJ

    更新日期:2004-09-01 00:00:00

  • Costs and outcomes of early versus delayed migraine treatment with sumatriptan.

    abstract:OBJECTIVE:To evaluate the impact on costs and outcomes of early migraine treatment with sumatriptan while pain is mild versus sumatriptan treatment of moderate to severe pain. BACKGROUND:Migraines result in substantial pain, impairment, and costs. Recent clinical studies have shown that early treatment with sumatripta...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.2002.02228.x

    authors: Halpern MT,Lipton RB,Cady RK,Kwong WJ,Marlo KO,Batenhorst AS

    更新日期:2002-11-01 00:00:00

  • The association between migraine and juvenile stroke: a case-control study.

    abstract:BACKGROUND:Several studies suggest an association between migraine and juvenile stroke. Because of some shortcomings, we designed another case-control study of a homogenous group of patients with juvenile cerebral ischemia. This study is part of a larger German epidemiological research project on the association of mig...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.2003.03023.x

    authors: Schwaag S,Nabavi DG,Frese A,Husstedt IW,Evers S

    更新日期:2003-02-01 00:00:00

  • Antihistamine responsive cluster headache in a teenaged girl.

    abstract::Episodic cluster headache is a well-recognized entity usually starting in the second decade of life. Uncommonly, the first typical symptoms may present in the first decade of life, but are rarely recognized as such during childhood. We report a 12-year-old girl who presented with a 1-year history of bouts of right-sid...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.1997.3705296.x

    authors: Neubauer D,Kuhar M,Ravnik IM

    更新日期:1997-05-01 00:00:00

  • A review of needle-free sumatriptan injection for rapid control of migraine.

    abstract::The treatment of migraine was transformed in 1992 with the introduction of the first triptan-based therapy, subcutaneous (SC) sumatriptan. SC sumatriptan has high efficacy and a rapid onset of action compared with other available triptans and formulations presumably because of its short Tmax, high Cmax, and avoidance ...

    journal_title:Headache

    pub_type: 杂志文章,评审

    doi:10.1111/head.12183

    authors: Rothrock JF,Freitag FG,Farr SJ,Smith EF 3rd

    更新日期:2013-09-01 00:00:00

  • Nasal sprays for the treatment of migraine.

    abstract::If you vomit with migraines, get full-blown migraines upon awakening, or want rapid relief without injections, consider a nasal spray. Options include triptans (zolmitriptan [Zomig] or sumatriptan [Imitrex]), DHE (Migranal), or an NSAID (Sprix). ...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.12045

    authors: Tepper DE

    更新日期:2013-03-01 00:00:00

  • Internalizing Symptoms in Pediatric Migraine: A Systematic Review Protocol.

    abstract:OBJECTIVES:The primary objective of the proposed systematic review is to determine if there is an association between internalizing disorders and symptoms (ie, subclinical symptoms) and migraine in children and adolescents. METHODS:We will perform a peer-reviewed Peer Review of Electronic Search Strategies search of M...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.13778

    authors: Falla K,Ronksley P,Noel M,Orr SL

    更新日期:2020-04-01 00:00:00

  • Concepts and mechanisms of migraine chronification.

    abstract::Migraine is a chronic recurrent disorder with episodic manifestations that is progressive in some individuals. Migraine progresses clinically, physiologically, and anatomically. Progression may be a consequence of the mechanisms that generate the migraine attacks (eg, cortical spreading depression) or it may be a func...

    journal_title:Headache

    pub_type: 杂志文章,评审

    doi:10.1111/j.1526-4610.2007.00969.x

    authors: Bigal ME,Lipton RB

    更新日期:2008-01-01 00:00:00

  • Correlations of headache diary parameters, quality of life and disability scales.

    abstract:OBJECTIVE:We aimed to investigate (1) to which extent headache diary variables correlate among each other; (2) to which extent they correlate with generic measures of quality of life and disability; (3) and whether correlations vary over time. METHODS:We performed a secondary analysis of data from 301 patients sufferi...

    journal_title:Headache

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1526-4610.2009.01434.x

    authors: Hoppe A,Weidenhammer W,Wagenpfeil S,Melchart D,Linde K

    更新日期:2009-06-01 00:00:00

  • Headache in patients with baroreflex failure.

    abstract::Two cases of baroreflex failure presented with tension-type/exertional headache. The usefulness of noninvasive physiological tests in diagnosing baroreflex failure and the role of baroreceptors in trigeminal nociception are discussed. ...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.2006.00514_3.x

    authors: Khurana RK

    更新日期:2006-07-01 00:00:00

  • Migraine and stroke: a continuum of association in adults.

    abstract::Migraine and stroke are the most common neurovascular disorders affecting adults. Migraine, particularly with aura, is associated with increased stroke risk both during and between attacks; as such, migraine may be viewed as a potentially modifiable risk factor for stroke. The exact mechanism by which migraine can pre...

    journal_title:Headache

    pub_type: 杂志文章,评审

    doi:10.1111/head.12115

    authors: Alhazzani A,Goddeau RP

    更新日期:2013-06-01 00:00:00

  • Respiratory studies in SUNCT syndrome.

    abstract::Seven SUNCT patients (six men, one woman) took part in this study. In four patients, respiratory variables were compared during and outside attacks. In five patients, peripheral chemosensitivity was tested and compared with a control group matched with respect to age, sex, and smoking habits. The results indicate that...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.1995.hed3506344.x

    authors: Kruszewski P,White LR,Shen JM,Pareja JA,Zhao JM,Schaanning J,Sjaastad O

    更新日期:1995-06-01 00:00:00

  • Chronic paroxysmal hemicrania and hemicrania continua: lack of efficacy of sumatriptan.

    abstract::Attacks of chronic paroxysmal hemicrania are prevented by the continuous administration of indomethacin. Sumatriptan, an agonist of 5-HT1-like receptors, has proven effective in the treatment of cluster headache attacks. There are clear clinical similarities between chronic paroxysmal hemicrania and cluster headache. ...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.1998.3803197.x

    authors: Antonaci F,Pareja JA,Caminero AB,Sjaastad O

    更新日期:1998-03-01 00:00:00

  • Long-term tolerability of telcagepant for acute treatment of migraine in a randomized trial.

    abstract:OBJECTIVE:To evaluate the long-term tolerability of telcagepant for acute treatment of intermittent migraine attacks. Background.- Telcagepant is a calcitonin gene-related peptide (CGRP) receptor antagonist being investigated for the acute treatment of migraine. METHODS:Migraine patients were randomized 2:1 to double-...

    journal_title:Headache

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1526-4610.2010.01799.x

    authors: Connor KM,Aurora SK,Loeys T,Ashina M,Jones C,Giezek H,Massaad R,Williams-Diaz A,Lines C,Ho TW

    更新日期:2011-01-01 00:00:00

  • Migraine consultations: a triangle of viewpoints.

    abstract::Several studies have examined patients' attitudes to a consultation for migraine and other headaches. However, a patient's assessment of the problem for which they seek treatment may differ from that of the referring primary physician which may, in turn, differ from the specialist's. This study set out to examine this...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.1995.hed3502104.x

    authors: Blau JN,MacGregor EA

    更新日期:1995-02-01 00:00:00

  • Cluster headache with obstructive sleep apnea and periodic limb movements during sleep: a case report.

    abstract::We report the case of a man with episodic cluster headache who suffered from severe obstructive sleep apnea (OSA) as well as periodic limb movements during sleep (PLMS). His attacks of headache occurred primarily during sleep being timely to REM sleep as 90 to 120 minutes interval. OSAs were more frequent and prolonge...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.2005.t01-3-05013.x

    authors: Pelin Z,Bozluolcay M

    更新日期:2005-01-01 00:00:00

  • Quantitative MRI studies of chronic brain white matter hyperintensities in migraine patients.

    abstract:OBJECTIVE:The aim of this study was to examine chronic brain white matter hyperintensities in migraine and to gain data on the characteristics of the lesions. BACKGROUND:Migraine associates with a higher incidence of magnetic resonance imaging (MRI)-visible white matter signal abnormalities. Several attack-related pat...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.12013

    authors: Aradi M,Schwarcz A,Perlaki G,Orsi G,Kovács N,Trauninger A,Kamson DO,Erdélyi-Bótor S,Nagy F,Nagy SA,Dóczi T,Komoly S,Pfund Z

    更新日期:2013-05-01 00:00:00

  • Platelet serotonin measures in migraine.

    abstract:OBJECTIVE AND BACKGROUND:Serotonergic mechanisms play an important role in the pathogenesis of headache. To search for potential indicators of altered serotonin homeostasis in migraine, we have investigated three parameters of the platelet serotonin (5HT) system, platelet serotonin level (PSL), platelet serotonin uptak...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.2002.02145.x

    authors: Jernej B,Vladić A,Cicin-Sain L,Hranilović D,Banović M,Balija M,Bilić E,Sucić Z,Vukadin S,Grgicević D

    更新日期:2002-07-01 00:00:00

  • Dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine.

    abstract:OBJECTIVE/BACKGROUND:The role of diet in migraine is not well understood. We sought to characterize usual dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine. We also examined whether the relationship between migraine and diet differs by w...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.12527

    authors: Evans EW,Lipton RB,Peterlin BL,Raynor HA,Thomas JG,O'Leary KC,Pavlovic J,Wing RR,Bond DS

    更新日期:2015-04-01 00:00:00

  • The discovery and development of the triptans, a major therapeutic breakthrough.

    abstract::The drug discovery programs that led to the development of the triptans were determined by the membership of the American Headache Society to be the most important breakthrough in headache medicine in the last 50 years. Dr. Humphrey, who spearheaded the drug discovery, recounts the pioneering work that took place and ...

    journal_title:Headache

    pub_type: 历史文章,杂志文章

    doi:10.1111/j.1526-4610.2008.01097.x

    authors: Humphrey PP

    更新日期:2008-05-01 00:00:00

  • Pathological contrast enhancement of the oculomotor and trigeminal nerves caused by intracranial hypotension syndrome.

    abstract::The typical symptom of intracranial hypotension syndrome is orthostatic headache. The headache may also be accompanied by neck pain and stiffness, low backache, radicular symptoms, quadriplegia, interscapular pain, nausea/vomiting, and cranial nerve involvement symptoms (hearing and visual problems, face pain and numb...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.2010.01825.x

    authors: Albayram S,Asik M,Hasiloglu ZI,Dikici AS,Erdemli HE,Altintas A

    更新日期:2011-05-01 00:00:00

  • Transient Global Amnesia Triggered by Migraine in a French Tertiary-Care Center: An 11-Year Retrospective Analysis.

    abstract:OBJECTIVE:The etiology of transient global amnesia (TGA) remains unclear, and flow disturbances in the mesial temporal lobes secondary to venous congestion have been proposed as a potential cause. The occurrence of TGA during a migraine attack is a rare condition. METHODS:This 11-year retrospective study in one French...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.12545

    authors: Donnet A

    更新日期:2015-06-01 00:00:00

  • Growth environment and personality in adult migraineurs and their migraine-free siblings.

    abstract::The aim of the study was to compare adult migraine discordant full siblings in terms of personality and psychosocial environment during childhood. The study, involving 30 sibling pairs and use of various personality instruments (Eysenck Personality Inventory [EPI], Color Word Test [CWT], Visual Aftereffects [VAE], Met...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.1997.3703159.x

    authors: Persson B

    更新日期:1997-03-01 00:00:00

  • Familial hemiplegic migraine with crossed cerebellar diaschisis and unilateral meningeal enhancement.

    abstract::A 6-year-old boy with a family history of hemiplegic migraine had a hemiplegic migraine lasting for 6 days complicated by prolonged fever, lethargy, and two brief focal seizures. An acute single photon emission computerized tomogram (SPECT) demonstrated decreased blood flow in the symptomatic cerebral hemisphere as we...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1046/j.1526-4610.1997.3709590.x

    authors: Crawford JS,Konkol RJ

    更新日期:1997-10-01 00:00:00

  • Triptan education and improving knowledge for optimal migraine treatment: an observational study.

    abstract:BACKGROUND:It is generally felt that patient education and patient knowledge regarding triptan use for acute migraine management are important for successful and safe treatment. It is unclear how knowledgeable triptan users are regarding their triptan, how much education occurs when triptans are prescribed, and the imp...

    journal_title:Headache

    pub_type: 杂志文章,多中心研究

    doi:10.1111/head.12286

    authors: Baron EP,Markowitz SY,Lettich A,Hastriter E,Lovell B,Kalidas K,Dodick DW,Schwedt TJ,American Headache Society Headache Fellows Research Consortium.

    更新日期:2014-04-01 00:00:00

  • What Will it Take to Move the Needle for Headache Disorders? An Advocacy Perspective.

    abstract::Discrimination toward people living with migraine and other headache disorders is widespread and socially accepted. Stigma toward these diseases is both a manifestation of these discriminatory attitudes and a sustainer of them. For those living with migraine and headache disorders, stigma limits the full expression of...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.13913

    authors: Shapiro RE

    更新日期:2020-10-01 00:00:00

  • ACE inhibitors for prophylaxis of migraine headaches.

    abstract::Seventeen patients with migraine headaches, occurring at least twice a month, were successfully treated with an ACE inhibitor for prophylaxis. Most were given enalapril, some used lisinopril. Duration of treatment ranged from 3 months to 3 years. Side effects were generally not noted. Cough occurred in four patients. ...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/j.1526-4610.1995.hed3508470.x

    authors: Bender WI

    更新日期:1995-09-01 00:00:00

  • Migraine and Sport in a Physically Active Population of Students: Results of a Cross-Sectional Study.

    abstract:OBJECTIVE:In this study, we explored the relationship between migraine and sport in a physically active population of students, analyzing the risk of migraine among sporty students. BACKGROUND:The relationship between sport and migraine is controversial; moreover, several studies report on sport as a migraine trigger,...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.14015

    authors: Pilati L,Battaglia G,Di Stefano V,Di Marco S,Torrente A,Raieli V,Firenze A,Salemi G,Brighina F

    更新日期:2020-11-01 00:00:00

  • The safety of sumatriptan and naratriptan in pregnancy: what have we learned?

    abstract:OBJECTIVES:To monitor for a signal of major teratogenicity by determining the risk of all major defects following in utero exposure to sumatriptan and naratriptan. To monitor for unusual patterns of birth defects that might suggest teratogenicity. BACKGROUND:The prevalence of migraine is highest in women of childbeari...

    journal_title:Headache

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1526-4610.2009.01529.x

    authors: Cunnington M,Ephross S,Churchill P

    更新日期:2009-11-01 00:00:00

  • Migraine as a Cortical Brain Disorder.

    abstract:PURPOSE:Migraine is an exclusively human chronic disorder with ictal manifestations characterized by a multifaceted clinical complexity pointing to a cerebral cortical involvement. The present review is aimed to cover the clinical, neuroimaging, and neurophysiological literature on the role of the cerebral cortex in mi...

    journal_title:Headache

    pub_type: 杂志文章

    doi:10.1111/head.13935

    authors: Barbanti P,Brighina F,Egeo G,Di Stefano V,Silvestro M,Russo A

    更新日期:2020-10-01 00:00:00