Abstract/Details

Daily migraine prevention and its influence on resource utilization in the military health system


2006 2006

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Abstract (summary)

Migraine is a widespread and disabling neurological disorder with a substantial economic burden due to the frequency and severity of the disease. Daily migraine prevention is recommended for patients who experience regular migraine headaches. While the safety and efficacy of this treatment has been established, it is unclear what impact migraine prevention has on health care resource consumption. This study was undertaken to determine if the initiation of daily migraine prevention had an effect on ambulatory health care utilization compared to acute migraine treatment alone.

Administrative claims data from the Military Health System were used to conduct a retrospective, longitudinal cohort study of 8,436 beneficiaries who received both a diagnosis of headache and a prescription for a migraine-specific abortive medication over a two year time period from 1 October 2002 to 30 September 2004. Patients were categorized by exposure status to daily migraine prevention. New users (N = 1,144) were compared to subjects receiving acute headache treatment alone (N = 2,618) during 18 months of follow-up. A series of regression and matching estimators modeled the effect of prevention on ambulatory health care utilization while controlling for patient characteristics selected from Andersen's Behavioral Model of Health Care Utilization.

The study results showed that exposure to daily migraine prevention influenced ambulatory health care utilization in the Military Health System. Treatment with prevention resulted in lower rates of utilization relative to what new users of prevention would have consumed in the absence of treatment. Reductions in post-treatment spending observed among new users were primarily driven by declines in the use of non-emergent care services.

The results suggest that additional economic benefits could be realized by increasing the appropriate use of daily migraine prevention. Health care providers must play an important part in reaching this goal by targeting those individuals most likely to derive a benefit from treatment. Health policies that successfully identify untreated candidates for daily migraine prevention and encourage open discussions between providers and patients about individual patient preferences as well as the benefits and risks of prevention should be considered.

Indexing (details)


Subject
Pharmaceuticals;
Health care;
Migraine;
Health services utilization;
Armed forces
Classification
0572: Pharmaceuticals
0769: Health care
Identifier / keyword
Health and environmental sciences; Health system; Migraine; Military; Resource utilization
Title
Daily migraine prevention and its influence on resource utilization in the military health system
Author
Devine, Joshua W.
Number of pages
201
Publication year
2006
Degree date
2006
School code
0130
Source
DAI-B 67/08, Dissertation Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9780542835612
Advisor
Hadsall, Ronald S.
University/institution
University of Minnesota
University location
United States -- Minnesota
Degree
Ph.D.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
3230202
ProQuest document ID
305310050
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/305310050
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