Abstract: Objectives: To identify factors associated with taking preventive migraine medicines. Methods: The ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE Europe [OVERCOME (EU)], conducted in Spain and Germany, is part of an overarching study program that also includes the US and Japan. Inclusion criteria were reporting having a headache or migraine in the previous 12 month, and having migraine based on the modified International Classification of Headache Disorders-3 screening criteria or self-reported physician diagnosis of migraine. Only respondents who had ?4 monthly headache days and MIDAS score ?11 could indicate whether they took preventive migraine medicines at least once (yes/no) within the last 3 months. Univariate analysis, random forest, and Lasso regression were followed by a binary logistic regression to investigate the association between the outcome variable and the independent factors. Results are presented as odds ratios (OR); an OR >1 indicates higher likelihood of being in the "yes" category. Results: Of the 20,756 respondents to the survey, 4,521 were eligible to indicate whether they took preventive medicines, with 1,357 (female, 54.5%) and 3,164 (female, 73.0%) in the ?yes? and ?no? category, respectively. OR (95% CI): female vs male 0.566 (0.488-0.657); full-time employment vs not full-time 1.455 (1.256-1.686); self-diagnosed vs no 0.113 (0.068-0.189); allodynia no (0-2) vs yes (3+) 0.536 [0.457-0.628]; no interictal burden (MIBS score 0) vs severe interictal burden (MIBS score 5+) 0.203 [0.149-0.276]; MSQ Role Function Restrictive (RFR) 0.867 [0.804-0.934]. Conclusions: Male gender, full-time employment, not being self-diagnosed, presence of allodynia, severe interictal burden were associated with higher likelihood of taking preventive migraine medicines within the last 3 months. Higher MSQ RFR level predicts lower disability, and it is associated with a lower likelihood of ever taking preventive medicines. The identification of these factors may inform the clinicians on the use of preventive migraine medications.

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