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Utilisation of prescription and over-the-counter triptans: a cross-sectional study in Stockholm, Sweden

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Author information

Authors and Affiliations

  1. Department of Pharmaceutical Biosciences, Uppsala university, Box 591, Uppsala, SE-751 24, Sweden

    Pia Frisk

  2. Department of Healthcare development, Public Healthcare Services Committee, Stockholm County Council, Box 6909, Stockholm, SE-102 39, Sweden

    Pia Frisk, Gunnar Ljunggren & Björn Wettermark

  3. Department of Pharmacy, Section for Social and Clinical Pharmacy, University of Copenhagen, Universitetsparken 2, Copenhagen, DK-2100, Denmark

    Sofia K Sporrong

  4. Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Berzelius väg 3, Stockholm, SE-171 77, Sweden

    Gunnar Ljunggren

  5. Clinical Pharmacology and Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Clinical Epidemiology Unit T2, Karolinska University Hospital, Solna, Stockholm, SE-171 76, Sweden

    Björn Wettermark

  6. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, Stockholm, SE-118 83, Sweden

    Mia von Euler

  7. Department of Clinical Pharmacology L7:03, Karolinska University Hospital, Solna, SE-171 76, Sweden

    Mia von Euler

Authors
  1. Pia Frisk
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  2. Sofia K Sporrong
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  4. Björn Wettermark
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Corresponding author

Correspondence to Pia Frisk.

Ethics declarations

The study was reviewed and approved by the Regional Ethical Review Board in Stockholm.

Conflict of interest

The authors declare that they have no conflict of interest.

Contribution of authors

All authors were involved in the design of the study and the questionnaire. GL extracted the data for the register part of the study, PF supervised the survey data collection, performed analyses and statistical calculations and drafted the article. All authors critically reviewed the article and approved the final version.

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Frisk, P., Sporrong, S.K., Ljunggren, G. et al. Utilisation of prescription and over-the-counter triptans: a cross-sectional study in Stockholm, Sweden. Eur J Clin Pharmacol 72, 747–754 (2016). https://doi.org/10.1007/s00228-016-2028-y

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  • DOI: https://doi.org/10.1007/s00228-016-2028-y

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