Educational intervention to reduce triptan overuse in primary care: a quality-improvement study

<h3>Introduction</h3> Triptan overuse is a well-established risk factor for medication overuse headache (MOH). Educational interventions have been shown to reduce medication usage in patients with a diagnosis of MOH. We aimed to assess whether education strategies in primary care can reduce triptan use in patients overusing triptans. <h3>Methods</h3> An information leaflet on triptan overuse and MOH was developed. Patient records at a primary care partnership were searched to identify patients collecting repeat triptan prescriptions. Patients diagnosed with cluster headache were excluded. Triptan over- users (classified as taking &gt;9 triptans monthly for &gt;3 months, based on NICE guidelines) were contacted by text with the leaflet and an invitation to book a consultation. Consultation outcome was recorded. <h3>Results</h3> 48 patients were contacted; all had a diagnosis of migraine. 6 (12.5%) patients responded, while 42 did not respond. 3 non-responders had diagnoses of chronic headache and 2 of MOH while no non-responders had diagnoses of these conditions. Amongst responders, mean monthly-triptans used was 15.1 compared to 13.5 in non-responders. Of responders, 33% reduced their triptan use following consultation, 50% made no changes following consultation and 18% did not book an appointment. <h3>Conclusion</h3> Patient education in primary care modestly reduces triptan use in over-users.