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This real-world study analyzed 1,572,698 adults with chronic migraine using the Epic Cosmos EHR database. Refractory migraine, defined as treatment with all 5 preventive medication classes, was identified in 2.5% of patients. Health care utilization increased significantly with each additional medication class, including ED visits (+9.2%), DHE use (+6.1%), & MRI orders (+4.9%). Among refractory patients, 94.6% had ≥1 comorbidity; anxiety (78.1%) and depression (71.5%) were most common (P<0.001).
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This real-world study analyzed 1,572,698 adults with chronic migraine using the Epic Cosmos EHR database. Refractory migraine, defined as treatment with all 5 preventive medication classes, was identified in 2.5% of patients. Health care utilization increased significantly with each additional medication class, including ED visits (+9.2%), DHE use (+6.1%), & MRI orders (+4.9%). Among refractory patients, 94.6% had ≥1 comorbidity; anxiety (78.1%) and depression (71.5%) were most common (P<0.001).
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