The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.

PHILADELPHIA — During a migraine attack, experiencing nausea with and without vomiting is associated with nonadherence to acute migraine medication (AMM) guidelines, according to a study presented at the American Academy of Neurology 2019 Annual Meeting in Philadelphia, Pennsylvania, from May 4 to 10.

AMM treatment guidelines say that the medication should not be used more than 15 days a month, and should be taken early on in a migraine attack. Nonadherence to AMM treatment guidelines may increase headache frequency and migraine-related disability. The objective of this study was to predict nonadherence to AMM guidelines, based on patient- and headache-specific factors.

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This study included 193 patients with migraine who had prescriptions from a Midwest healthcare system for either triptan or ergot. Participants completed a survey of demographic information such as education, personal income, and sex, as well as a 3-month electronic headache diary including the characteristics of the attack and medication use. If the medication was taken when the pain was mild, it was considered to be taken early.

Participants were mostly women (91.7%), mostly Caucasian (92.2%), and aged 18 to 64 years. The average personal income was above $50,000 annually, and 63.7% had an undergraduate degree.

The investigators found that migraine attacks with nausea (odds ratio, 0.22; 95% CI, 0.16-0.33), or nausea with vomiting (odds ratio, 0.04; 95% CI, 0.02-0.18), were associated with lower odds of using AMM early compared with migraines with no nausea. Compared with participants who made $50,000 or less annually, participants who made more than $50,000 a year were more likely to take AMMs (odds ratio, 2.04; 95% CI, 1.33-3.12). Sex and having an undergraduate degree were not associated with early AMM use.

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In conclusion, nonadherence to AMM treatment guidelines is associated with nausea with and without vomiting during a migraine attack. People with lower annual incomes are not as likely to adhere to AMM guidelines.

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Lofchie A, Butler N, Robbins M, Seng E. Predictors of non- adherence with acute migraine medications. Presented at the American Academy of Neurology 2019 Annual Meeting; May 4-10, 2019; Philadelphia, PA.

This article originally appeared on Neurology Advisor