Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Canadian Institute for Health Information, Toronto, ON, Canada.
Headache. 2015 Jul-Aug;55 Suppl 4:212-20. doi: 10.1111/head.12508. Epub 2015 Mar 7.
Public drug coverage for triptan medications varies across jurisdictions in Canada, which may lead to differences in usage patterns and patient risk for medication overuse headache.
We conducted a population-based, cross-sectional analysis of publicly funded triptan use in seven provinces across Canada from January 1, 2012 to December 31, 2012. All patients who had filled at least one prescription for a triptan during the study period were included. We defined quantity limits of 6, 12, and 18 triptan units per month to assess the prevalence of high volumes of triptan use, which may place patients at risk for medication overuse headaches, and compared this prevalence between provinces with different funding restrictions.
We identified 14,085 publicly funded users of triptans in 2012 in the seven provinces studied, 82.5% of whom were aged less than 65 years (N = 11,631). The prevalence of triptan use ranged substantially by province, from 0.04% in Ontario to a maximum of 1.0% in Manitoba (P < .001). Furthermore, the percentage of patients in each province using more than 6, 12, or 18 units per month differed significantly between provinces (P < .001). In particular, the percentage of patients treated with more than 6 units per month ranged from as low as 2.1% in Saskatchewan to 43.8% in Ontario.
Differing public drug reimbursement criteria for triptans may be one contributing factor that has led to our observation of considerable variation in both prevalence of triptan prescribing and potential overuse of these medications. We offer that monthly quantity limits may be considered as a tool to decrease risks for medication overuse headache.
在加拿大，不同司法管辖区的公共药物覆盖范围因曲坦类药物而异，这可能导致使用模式和药物过度使用性头痛的患者风险存在差异。
我们对加拿大七个省份 2012 年 1 月 1 日至 12 月 31 日期间公共资助的曲坦类药物使用情况进行了基于人群的横断面分析。所有在研究期间至少开了一种曲坦类药物处方的患者都被纳入研究。我们定义了每月 6、12 和 18 个曲坦单位的数量限制，以评估高剂量曲坦类药物使用的流行率，这可能使患者面临药物过度使用性头痛的风险，并比较了不同资助限制省份之间的这种流行率。
我们在 2012 年确定了加拿大七个省份 14085 名公共资助的曲坦类药物使用者，其中 82.5%年龄小于 65 岁（n=11631）。曲坦类药物使用的流行率因省份而异，从安大略省的 0.04%到马尼托巴省的 1.0%（P<0.001）。此外，每个省份每月使用超过 6、12 或 18 个单位的患者比例在省份之间有显著差异（P<0.001）。特别是，每月使用超过 6 个单位的患者比例从萨斯喀彻温省的 2.1%到安大略省的 43.8%不等。
曲坦类药物公共药物报销标准的不同可能是导致我们观察到曲坦类药物处方的流行率和潜在过度使用存在显著差异的一个因素。我们认为每月数量限制可以作为降低药物过度使用性头痛风险的一种工具。
