This study described healthcare providers' (HCPs) perspectives and prescribing behaviors of short-term prevention (STP) in real-world settings.
STP provides migraine prevention for a short period of time in anticipation of or during exposure to known triggers/stressors, which may offer patients greater control.
HCPs who were aware of STP treatment (primary care providers [n=54], nurse practitioners/physician assistants [n=49], headache specialists [n=104], and other neurologists [n=70]) completed a cross-sectional survey between August-September 2024. HCPs self-reported their demographics, STP treatment perceptions, medications and characteristics of patients prescribed for STP treatment. Descriptive statistics were reported for the total sample.
Most HCPs were aged 40-59 (53.1%) and male (65.3%); 48.0% practiced in major metropolitan or urban area. Over 90% agreed that migraine regimens should provide patients with the greatest flexibility to manage migraine. Over 80% were likely to recommend STP treatment to patients prior to trigger exposure (e.g., exercise), increased period of risk (e.g., menstruation), and during a period when migraine attack prevention is particularly desired (e.g., upcoming vacation).
The most frequently prescribed medications for STP were gepants (71.9%), followed by nonsteroidal anti-inflammatory drugs (60.6%) and oral triptans (59.8%). Rimegepant was most prescribed among gepant prescribers (94.4%); the primary driver for choice of gepant was indications for both acute and preventive treatment of migraine (62.7%). The main characteristics of patients currently being prescribed with a STP regimen were having menstrual migraine (83.3%) and the ability to predict a migraine trigger (78.2%).
Findings suggest that HCPs believe patients with migraine, particularly those with perimenstrual migraine attacks, could benefit from the added control and flexibility of STP treatment. Further research is necessary to explore STP, which could enhance migraine care for patients.