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Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study.

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Title: Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study.
Authors: Shapiro, Hannah F. J., Loder, Elizabeth, Shapiro, Daniel J.
Source: Headache: The Journal of Head & Face Pain. Oct2023, Vol. 63 Issue 9, p1232-1239. 8p.
Subjects: Research, Neurologists, Confidence intervals, Migraine, Pediatrics, Retrospective studies, Acquisition of data, Preventive health services, Comparative studies, Drugs, Drug prescribing, Medical records, Descriptive statistics, Research funding, Physician practice patterns, Logistic regression analysis, Odds ratio, Medical specialties & specialists, Longitudinal method, Adults, Children
Abstract: Objective: We aimed to compare the prescribing patterns of preventive medications between pediatric and adult neurologists for young adults with migraine. Background: Although preventive medications are effective for adults with migraine, studies in children have failed to demonstrate similar efficacy. As a result, lifestyle modifications and non‐pharmacological interventions are often emphasized in children. It is not known whether young adults are prescribed preventive medications at different rates according to whether they are cared for by an adult or pediatric neurologist. Methods: We performed a multicenter retrospective cohort analysis of patients with migraine aged 18–25 years who were seen by a pediatric or adult neurologist at Mass General Brigham Hospital between 2017 and 2021. The primary outcome was whether the patient received a prescription for any preventive medication during the study period. Results: Among the 767 included patients, 290 (37.8%) were seen by a pediatric neurologist. Preventive medications were prescribed for 131/290 (45.2%; 95% confidence interval [CI]: 39.5%, 51.0%) patients seen by a pediatric neurologist and 206/477 (43.2%; 95% CI: 39.0%, 47.7%) patients seen by an adult neurologist (p = 0.591). In the mixed effects logistic regression model, clinician specialty was not associated with preventive medication use (adjusted odds ratio [AOR] 1.20, 95% CI: 0.62, 2.31). Female sex (AOR 1.69, 95% CI: 1.07, 2.66) and number of visits during the study period (AOR 1.64, 95% CI: 1.49, 1.80) were associated with receiving preventive medication. Conclusion: Approximately two fifths of young adults with migraine were prescribed preventive medications, and this proportion did not differ according to clinician specialty. Although these findings suggest that pediatric and adult neurologists provide comparable care, both specialties may be underusing preventive medications in this patient population. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Shapiro%2C+Hannah+F%2E+J%2E%22">Shapiro, Hannah F. J.</searchLink><br /><searchLink fieldCode="AR" term="%22Loder%2C+Elizabeth%22">Loder, Elizabeth</searchLink><br /><searchLink fieldCode="AR" term="%22Shapiro%2C+Daniel+J%2E%22">Shapiro, Daniel J.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. Oct2023, Vol. 63 Issue 9, p1232-1239. 8p.
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– Name: Abstract
  Label: Abstract
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  Data: Objective: We aimed to compare the prescribing patterns of preventive medications between pediatric and adult neurologists for young adults with migraine. Background: Although preventive medications are effective for adults with migraine, studies in children have failed to demonstrate similar efficacy. As a result, lifestyle modifications and non‐pharmacological interventions are often emphasized in children. It is not known whether young adults are prescribed preventive medications at different rates according to whether they are cared for by an adult or pediatric neurologist. Methods: We performed a multicenter retrospective cohort analysis of patients with migraine aged 18–25 years who were seen by a pediatric or adult neurologist at Mass General Brigham Hospital between 2017 and 2021. The primary outcome was whether the patient received a prescription for any preventive medication during the study period. Results: Among the 767 included patients, 290 (37.8%) were seen by a pediatric neurologist. Preventive medications were prescribed for 131/290 (45.2%; 95% confidence interval [CI]: 39.5%, 51.0%) patients seen by a pediatric neurologist and 206/477 (43.2%; 95% CI: 39.0%, 47.7%) patients seen by an adult neurologist (p = 0.591). In the mixed effects logistic regression model, clinician specialty was not associated with preventive medication use (adjusted odds ratio [AOR] 1.20, 95% CI: 0.62, 2.31). Female sex (AOR 1.69, 95% CI: 1.07, 2.66) and number of visits during the study period (AOR 1.64, 95% CI: 1.49, 1.80) were associated with receiving preventive medication. Conclusion: Approximately two fifths of young adults with migraine were prescribed preventive medications, and this proportion did not differ according to clinician specialty. Although these findings suggest that pediatric and adult neurologists provide comparable care, both specialties may be underusing preventive medications in this patient population. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=172990783
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      – Type: doi
        Value: 10.1111/head.14628
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      – Code: eng
        Text: English
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        PageCount: 8
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    Subjects:
      – SubjectFull: Research
        Type: general
      – SubjectFull: Neurologists
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Migraine
        Type: general
      – SubjectFull: Pediatrics
        Type: general
      – SubjectFull: Retrospective studies
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      – SubjectFull: Acquisition of data
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      – SubjectFull: Preventive health services
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      – SubjectFull: Comparative studies
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      – SubjectFull: Drugs
        Type: general
      – SubjectFull: Drug prescribing
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Research funding
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      – SubjectFull: Physician practice patterns
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      – SubjectFull: Logistic regression analysis
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      – SubjectFull: Odds ratio
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      – SubjectFull: Medical specialties & specialists
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      – SubjectFull: Longitudinal method
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      – SubjectFull: Adults
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      – SubjectFull: Children
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    Titles:
      – TitleFull: Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study.
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            NameFull: Shapiro, Hannah F. J.
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              Text: Oct2023
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              Y: 2023
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