Abstract
Objective: To evaluate the prevalence of migraine and compare the prescribing practices of different General Physicians and Neuro
Physicians to choose different anti migraine drugs.
Study Design: A Prospective cohort study.
Place and Duration: Study performed during the period of 12th October, 2017 to 5th September, 2018 at Outpatient Departments
(General Physicians and Neurology) of different hospitals of Karachi.
Methodology: Data was obtained by a qualified clinical pharmacist in the form of duplicate prescriptions and also from migraine
patients with their consent. Variables which were compared in prescribing practices of different GPs and NPs included, different
class of drugs prescribed, polytherapy, mean cost of drugs per prescription, prescribed drugs by its generic name, ratios of
antimigraine drugs dosages. Besides, another variable was the estimation of prevalence of migraine among males and females.
Results: Among total of 319 reviewed prescriptions analgesics were the most prescribed medications in migraine therapy by both
Practitioners i.e. General Physicians (88.8%) and Neuro Physicians (82.3%). The average number of drugs per prescriptions by
General Physicians and Neuro Physicians was 6.10 and 3.98 respectively. The cost of treatment (per prescription) was much higher
by Neuro Physicians (Rs. 88.4) than General Physicians (Rs. 58.9). The prescribing ratio of generic drugs is comparable between
General Physicians (48.09%) and Neuro Physicians (34.10%). Naproxen (1.45 vs 0.97) and Ergotamine (1.24 vs 1.1) were prescribed
in higher doses by General Physicians than Neuro Physicians. This study also indicated that the incidence ratio of migraine among
females (58.9%) was much higher than males (41.0%).
Conclusion: Polypharmacy and discrepancies in daily dosages of anti-migraine drugs were more found in prescribing pattern of
General Physicians. However, cost effective treatment by General Physician was noticed due to higher ratio of generic drugs. Higher
incidence ratio of migraine was observed among female
Kamran Khan, Mudassar Iqbal Arain, Muhammad Ali Ghoto, Abdullah Dayo, Mehrukh Zehravir, Ahad Abdul Rehman, Muhammad Arif Asgha. (2019) Prescribing trends of antimigraine drugs amongst general physicians and neuro physicians in southern Pakistan: A comparative approach, Isra Medical Journal, Volume 11, Issue 4 (Part-B).
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