OBJECTIVES: Chronic migraine (CM) is a disabling disorder that significantly reduces quality of life. Guidelines recommend preventive medications as the standard of care for patients with frequent migraine. Real-world analyses have shown that adherence and persistence to oral migraine preventive medications (OMPMs) is poor. However, previous research has focused on specific individual OMPM. Few studies to date have explored adherence and persistence to any OMPM. This research aims to assess OMPM persistence and adherence among newly diagnosed CM patients. METHODS: A retrospective analysis of medical and pharmacy claims from the Scott and White Health Plan. First documentation of CM diagnosis from December 2011 to December 2013 was defined as the index date. Patients were required to be ≥18 years of age, and have continuous enrollment 6 months pre-index and 12 months post-index. The proportion of days covered (PDC) was calculated for all patients with at least 2 fills for any of the 25 included OMPMs. PDC was assessed from the first OMPM fill date to the end of the follow-up period (12 months post index diagnosis). A PDC cutoff ≥0.8 was used to classify adherence. Non-persistence was defined as an OMPM supply gap >45 days. RESULTS: Of the 283 eligible CM patients enrolled into the study, 221 (78.1%) patients had at least 1 OMPM fill and were included in the persistence analysis, and 203 (71.7%) patients had at least 2 OMPM fills and were included in the adherence analysis. The mean [standard deviation] PDC was 0.76 [0.25]. Using a PDC cut-off of ≥0.8, 117 (57.6%) CM patients were adherent to any OMPM. Forty-six (20.8%) CM patients did not persist with any OMPM. The mean time to treatment discontinuation was 89.4 days [68.2 days].  CONCLUSIONS: This real-world study demonstrated low adherence and persistence to any OMPM among CM patients.