1. Clinical Characteristics and Treatment Patterns Among Patients Diagnosed With Cluster Headache in U.S. Healthcare Claims Data
- Author
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Janet H. Ford, Rebecca L. Robinson, Casey Choong, James M. Martinez, Allen W. Nyhuis, Sheena K. Aurora, and Shivang Joshi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Substance-Related Disorders ,Cluster Headache ,Comorbidity ,Research Submissions ,Suicidal Ideation ,Cohort Studies ,Insurance Claim Review ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,clinical characteristics ,Suicidal ideation ,matched case–control study ,Aged ,Retrospective Studies ,business.industry ,Cluster headache ,claims database ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Tryptamines ,United States ,Analgesics, Opioid ,Treatment Outcome ,treatment patterns ,Neurology ,Propensity score matching ,Physical therapy ,Anxiety ,Female ,Neurology (clinical) ,medicine.symptom ,Trigeminal autonomic cephalalgia ,business ,Administrative Claims, Healthcare ,030217 neurology & neurosurgery ,Cohort study - Abstract
Objective To characterize demographics, clinical characteristics, and treatment patterns of patients with cluster headache (CH). Background CH is an uncommon trigeminal autonomic cephalalgia with limited evidence‐based treatment options. Patients suffer from extremely painful unilateral headache attacks and autonomic symptoms with episodic and chronic cycles. Design/Methods This retrospective analysis used insurance claims from Truven Health Analytics MarketScan® research databases from 2009 to 2014. Two cohorts were compared: CH patients (with ≥2 CH claims) were propensity score matched with 4 non‐headache controls, all with continuous enrollment for 12 months before and after the date of first CH claim or matched period among controls. Results CH patients (N = 7589) were mainly male (57.4%) and 35‐64 years old (73.2%), with significantly more claims for comorbid conditions vs controls (N = 30,341), including depressive disorders (19.8% vs 10.0%), sleep disturbances (19.7% vs 9.1%), anxiety disorders (19.2% vs 8.7%), and tobacco use disorders (12.8% vs 5.3%), with 2.5 times greater odds of suicidal ideation (all P 12 unique prescription drug claims. Most commonly prescribed drug classes for CH patients included: opiate agonists (41%), corticosteroids (34%), 5HT‐1 agonists (32%), antidepressants (31%), NSAIDs (29%), anticonvulsants (28%), calcium antagonists (27%), and benzodiazepines (22%). Only 30.4% of CH patients received recognized CH treatments without opioids during the 12‐month post‐index period. These patients were less likely to visit emergency departments or need hospitalizations (26.8%) as compared to CH patients with no pharmacy claims for recognized CH treatments or opioids (33.6%; P
- Published
- 2017
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