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Utilisation of prescription and over-the-counter triptans: a cross-sectional study in Stockholm, Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. Stockholm Cty Council, Publ Healthcare Serv Comm, Dept Healthcare Dev, Box 6909, SE-10239 Stockholm, Sweden..
Univ Copenhagen, Dept Pharm, Sect Social & Clin Pharm, Univ Parken 2, DK-2100 Copenhagen, Denmark..
Stockholm Cty Council, Publ Healthcare Serv Comm, Dept Healthcare Dev, Box 6909, SE-10239 Stockholm, Sweden.;Karolinska Inst, Dept Learning Informat Management & Eth, Med Management Ctr, Berzelius Vag 3, SE-17177 Stockholm, Sweden..
Stockholm Cty Council, Publ Healthcare Serv Comm, Dept Healthcare Dev, Box 6909, SE-10239 Stockholm, Sweden.;Karolinska Univ Hosp, Clin Pharmacol, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Ctr Pharmacoepidemiol, Dept Med Solna, Karolinska Inst,Clin Epidemiol Unit T2, SE-17176 Stockholm, Sweden..
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2016 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 72, no 6, 747-754 p.Article in journal (Refereed) PublishedText
Abstract [en]

Triptans are widely used in acute migraine, and in some countries, they are also available over-the-counter (OTC). In Sweden, sales have increased for both prescription and OTC triptans. This study aimed to describe current prescribing and utilisation patterns of prescription and OTC triptans in Stockholm, Sweden. Register data from 4759 patients dispensed triptans in 2014 were used to study documented diagnosis of migraine, concomitant acute and preventive treatment for migraine, and contraindications. Survey data from 49 patients purchasing OTC triptans in three pharmacies were used to capture physician-diagnosed migraine, concomitant acute and preventive treatment for migraine, a behaviour of combining or alternating between prescription and OTC triptans, and pharmacy counselling rates. Among the prescription triptan users, 52 % had a recorded diagnosis of migraine, 48 % had no other acute treatment, preventive treatment was rare (12 %) and contraindications were found in 2 % of the patients. Among the OTC triptan users, the majority (63 %) had been diagnosed by a physician and had a history of prescription triptan use, but combining or alternating between OTC and prescription triptans was rare. Concomitant acute treatment was reported in 53 % and preventive treatment was rare (4 %), despite high self-reported migraine frequencies. Some off-label use was detected, despite moderate to high counselling rates. Triptans are prescribed with attention to safety but with poor recording of migraine diagnosis. OTC triptan users generally have a history of prescription triptan use. Preventive treatment rates are low in both groups. Strategies to discern patients who need other treatment options should be considered.

Place, publisher, year, edition, pages
2016. Vol. 72, no 6, 747-754 p.
Keyword [en]
Triptans, Over-the-counter, OTC, Drug utilisation, Prescription, Survey
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-298065DOI: 10.1007/s00228-016-2028-yISI: 000376245600014PubMedID: 26922586OAI: oai:DiVA.org:uu-298065DiVA: diva2:944878
Available from: 2016-06-30 Created: 2016-06-29 Last updated: 2016-06-30Bibliographically approved

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