Medication Use and Disability Among Migraineurs: A National Probability Sample Survey

OBJECTIVE: To measure the use of prescription medication in treating migraine headache and the associations between medication use and sociodemographic factors, and headache characteristics. DESIGN: National sample survey using a mailed questionnaire to determine symptoms accompanying or preceding severe headaches; frequency, duration, and disability from severe attacks: use of medications to control pain; and medical-care use for severe headaches. SETTING: A stratified sample of United States households. PATIENTS: A sample of 20,468 respondents, aged 12 to 80 years, who responded to a survey on "severe" headaches during the prior year. MEASUREMENTS AND MAIN RESULTS: Overall, 20.2% of respondents reported severe headaches. Migraine was found in 17.6% of females and 5.7% of males. Of the migraineurs, 40.1% of female and 28.3% of male migraineurs reported using prescription drugs to control pain. Blacks were less likely than whites to report prescription use. Insignificant differences were seen in rates of prescription use among various income levels and regions of the country. Use of prescription medication varied considerably by symptoms and characteristics of migraine attacks. Vomiting and sensory aura were most frequently associated with medication use, as were severity and duration of attacks. Use of urgent-care services for severe headache attacks was associated with frequent use of prescription medications. Patients who reported a physician diagnosis of migraine were more likely to use prescription medication than other migraineurs. CONCLUSIONS: Most migraineurs in the United States are not being treated with prescription medications. Many active migraine patients would benefit from appropriate treatment if care was sought and diagnosis made.