Association between TriptanUse and Cardiac Contraindications in an Insured Migraine Population

Background Safety concerns exist when using triptansto treat patients with cardiac contraindications. –Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors. –All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions. •Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors. Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans

Utilization of CT Scans and MRIs in an Insured Population with Migraine

Background: • Neuroimaging is a diagnostic tool that may be used to rule out a serious condition when a patient presents with head pain. It is not typically warranted for patients who have a normal neurologic exam, and may be over utilized despite established practice parameters set by the American Academy of Neurology. •A decision to use neuroimaging should consider the type of headache and presence of any clinical features that suggest a serious condition. Over-utilization of neuroimaging has cost and safety implications. The United States Headache Consortium, a panel of experts on migraine, set the guidelines for diagnosis and treatment in 2000. In alignment with these guidelines, the Migraine Quality of Care Measurement Set seeks to reveal patterns in CT and MRI utilization for migraine sufferers, which may inform future policy decisions at the health plan-level