OBJECTIVES:

Migraine affects 15.3% of the US adult population, accounts for 3% of all annual US emergency room visits, and costs $13 billion to the US employers. The burden of migraine is high with younger adults, unemployed, and those with family income <$35,000/year. Recent years have seen several new drugs approved for migraine treatment. With high prevalence and cost associated with migraine, and the introduction of new migraine medications, the study objectives were to determine the changes in rates of non-adherence with migraine medicines and to identify the main reasons for non-adherence between 2019 and 2021.

METHODS:

Data from the National Health and Wellness Study (NHWS), a self-administered, annual, internet-based cross-sectional survey of US adults from 2019 and 2021, was used. Non-adherence was measured using the Medication Adherence Reasons Scale (MAR-Scale) which includes 19 reasons for non-adherence and one global item. NHWS participants who self-reported taking daily prescription medication(s) to treat migraine responded to the MAR-Scale. MAR-Scale measures non-adherence “in the past 7 days”, on an 8-point scale ranging from 0 days to 7 days. Frequencies were used to identify reasons for non-adherence.

RESULTS:

NHWS data from 2019 to 2021 had 1,705 and 1,848 respondents, respectively. In both years, triptans, anticonvulsants, NSAIDs and opioids were the most frequently used medications. Based on the MAR-Scale, 50.32% of patients reported non-adherence to at least one reason in 2019; and 57.63% in 2021. While the most common reason in 2019 was concerns about the long-term effects and side effects, it changed to side effects in 2021. More respondents reported changes in medicine from 2019 to 2021 to reduce side effects. When non-adherent, patients reported missing their medicine for an average of 3.58 days in a week in both years.

CONCLUSIONS:

The significant increase in the non-adherence rate with migraine medications between 2019 and 2021 warrants further investigation.