{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:37:38Z","timestamp":1762076258311,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Understand health resource, medication use, and cost of adults with chronic migraine who received guideline\u2010recommended onabotulinumtoxinA (botulinum toxin) treatment frequency and then continued or reduced\/stopped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Botulinum toxin may be a beneficial treatment for chronic migraine; the trajectory of health resources utilization among those with continued or reduced\/stopped use is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective population\u2010based cohort study utilizing administrative data from Alberta, Canada (2012\u20132020), was performed. A cohort of adults who received \u22655 botulinum toxin treatment cycles for chronic migraine over 18\u2009months (6\u2010month run\u2010in; 1\u2010year pre\u2010index period) were grouped into those who (1) continued use (\u22653 treatments\/year), or (2) stopped or reduced use (stopped for 6\u2009months then received 0 or 1\u20132 treatments\/year, respectively) over a 1\u2010year post\u2010index period. Health resources and medication use were described, and pre\u2013post costs were assessed. A second cohort that received \u22653 treatments\/year immediately followed by 1\u2009year of stopped or reduced use was considered in sensitivity analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pre\u2013post health resource, medication use, and costs were similar among those with continued use (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093336). Among those who stopped or reduced use (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091099; 756 stopped, 343 reduced), health resource, medication use, and costs were lower in the post\u2010 (total median per\u2010person cost [IQR]: all\u2010cause $4851 [$8090]; migraine\u2010related $835 [$1915]) versus pre\u2010 (all\u2010cause $6096 [$7207]; migraine\u2010related $2995 [$1950]) index period (estimated cost ratios [95% CI]: total all\u2010cause 0.86 [0.79, 0.95]; total migraine\u2010related 0.44 [0.40, 0.48]). In the second cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093763), return to continued use (\u22653 treatments\/year) occurred in up to 70.4% in those with reduced use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Of adults treated with botulinum toxin for chronic migraine, 75.2% had continued use, stable health resource and medication use, and costs over a 2 year period. In those that stopped\/reduced use, the observed lower health resource and migraine medication use may indicate improved symptom control, but the resumption of guideline\u2010recommended treatment intervals after reduced use was common.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14613","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T08:34:47Z","timestamp":1692779687000},"page":"1285-1294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trajectory of health care resources among adults stopping or reducing treatment frequency of botulinum toxin for chronic migraine treatment in Alberta, Canada"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-8668","authenticated-orcid":false,"given":"Lawrence","family":"Richer","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry, Department of Pediatrics University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huong","family":"Luu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Real World Evidence Unit University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3400-7214","authenticated-orcid":false,"given":"Karen J. B.","family":"Martins","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Real World Evidence Unit University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khanh","family":"Vu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Real World Evidence Unit University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Guigue","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences and the Centre for Health Informatics University of Calgary, Cumming School of Medicine  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai On","family":"Wong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Real World Evidence Unit University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phuong Uyen","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences and the Centre for Health Informatics University of Calgary, Cumming School of Medicine  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thilinie","family":"Rajapakse","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Department of Pediatrics University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences and the Centre for Health Informatics University of Calgary, Cumming School of Medicine  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W.","family":"Klarenbach","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Real World Evidence Unit University of Alberta  Edmonton Alberta Canada"},{"name":"Faculty of Medicine and Dentistry, Department of Medicine University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410381145"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.192492"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01945.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01990.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-018-0921-8"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01766.x"},{"key":"e_1_2_11_8_1","unstructured":"NICE technology appraisal guidance 260.Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. 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