| アブストラクト | BACKGROUND: Previous work has highlighted that migraine is underdiagnosed and undertreated in primary care. AIM: To characterise diagnosis and treatment patterns among patients with migraine in England. DESIGN & SETTING: A retrospective cohort study using the Clinical Practice Research Datalink Aurum linked to the 2019 Index of Multiple Deprivation dataset. METHOD: The study cohort included patients presenting to general practices with migraine at age>/=18 years from September 2012 to May 2023 (index event). Prescribed medications 12 months after index were compared across sociodemographic stratifications (age, sex, ethnicity, and deprivation). Medication overprescription was defined as>/=10 days' (opioids/triptans) or>/=15 days' (analgesics/antipyretics/NSAIDs) supply in 3 consecutive months. RESULTS: 1,534,807 patients with any headache/migraine were observed attending primary care in England. 876 233 (57.1%) were coded with undifferentiated/unclassified headache and 606 928 (39.5%) with a primary headache disorder. Migraine was the most coded primary headache disorder, with 476 191 adults (78.5%), constituting the final sample used for subsequent analyses. Only 36.5% of the migraine cohort were prescribed preventive medication. 17.9% of those prescribed amitriptyline, 31.3% prescribed propranolol, and 31.2% prescribed topiramate reached SIGN 155/NICE CKS recommended doses. 62.6% of the migraine cohort were prescribed an acute medication: triptan (36.6%), opioid (9.6%). 23.6% of triptan users and 44.3% of opioid users exhibited medication overprescription, consistent with the ICHD-3 medication overuse definition. CONCLUSION: The majority of headache presenting to primary care remains undifferentiated/unclassified. Only one-third of patients diagnosed with migraine receive triptans or preventive medication. Acute medication overprescription is common and preventive medicines are poorly optimised. |
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| ジャーナル名 | BJGP open |
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| Pubmed追加日 | 2026/1/10 |
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| 投稿者 | Watson, David Pb; Pawinski, Robert; Czachorowski, Maciej; Araghi, Marzieh; Williams, Alannah M; Randall, Rowena; Camidge, Lucinda; Rottier, Elke; Gowman, Hannah; Law, Sarah; O'Neil, Grant |
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| 組織名 | Aberdeen Royal Infirmary, Aberdeen, UK.;Pfizer Ltd, Tadworth, UK.;Adelphi Real World, Bollington, UK.;Pfizer Ltd, Tadworth, UK grant.oneil@pfizer.com. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41513289/ |
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