Analysis of the management and costs of headache disorders in Spain during the period 2011–2016: a retrospective multicentre observational study

Darbà, Josep; Marsà, Alícia

doi:10.1136/bmjopen-2019-034926

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Our study findings indicate a high and increasing number of patients with physician-diagnosed migraine, consistent with published literature [ 7 , 36 ]. However, our reported prevalence of physician-diagnosed migraine (5.5% of all age population and 6.5% of people aged > 18 years old) is lower than prevalence estimates published for Spain, potentially due to differences in methodologies [ 36 , 37 ].…”

Section: Discussionsupporting

confidence: 92%

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Migraine treatment: quo vadis? Real-world data study (2015–2022) in Spain

Pozo-Rosich,

Carmo,

Muñiz

et al. 2024

BMC Neurol

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Background Migraine is a leading cause of disability, estimated to affect one-in-ten people in Spain. This study aimed to describe the management of migraine in Spain and identify improvement areas. Methods Non-interventional, retrospective, cross-sectional cohort study conducted using an electronic medical records database covering visits to public healthcare providers for 3% of the Spanish population. Patients with a migraine diagnosis (ICD-9 346) between 01/2015 and 04/2022 were included, as well as their demographic and clinical characteristics, prescribed migraine treatments and the specialty of the prescribing physicians. Results The database included 61,204 patients diagnosed with migraine. A migraine treatment had been prescribed to 50.6% of patients over the last 24 months (only acute to 69.5%, both acute and preventive to 24.2%, and only preventive to 6.3%). The most frequently prescribed treatments were NSAIDs (56.3%), triptans (44.1%) and analgesics (28.9%). Antidepressants were the most common preventive treatment (prescribed to 17.9% of all treated patients and 58.7% of those treated with a preventive medication), and anti-CGRP monoclonal antibodies the least prescribed (1.7%; 5.7%). In 13.4% of cases, preventive medications were the first treatment: alone in 5.8% of cases and together with an acute medication in 7.6%. A fifth of patients who were initially prescribed with only acute treatment were later prescribed a preventive medication (20.7%). On average, it took 29.4 months for this change to occur. Two-thirds of patients started their preventive treatment in primary care (64.2%). The percentage of patients treated by a neurologist increased with the number of received preventive medications. However, 28.8% of patients who had already been prescribed five or more distinct preventive treatments were not treated by a neurologist. Migraine patients had between 1.2- and 2.2-times higher prevalence of comorbidities than the general population, age-gender adjusted. Conclusions Our study emphasizes the need for improved management of migraine in Spain to reduce the risk of chronification and improve patient outcomes. More training and coordination across healthcare professionals is necessary to recognize and address risk factors for migraine progression, including multiple associated comorbidities and several lines of treatment, and to provide personalized treatment plans that address the complex nature of the condition.

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Section: Discussionsupporting

confidence: 92%

“…As expected, most migraine patients in our study were women of working age with several comorbidities [ 7 , 37 , 39 ]. The most frequently observed comorbidities were coexisting chronic pain (50.8%), metabolic (38.6%), neuropsychiatric (35%), digestive (25.4%), and cardiovascular (25.4%) conditions.…”

Section: Discussionsupporting

confidence: 66%

Migraine treatment: quo vadis? Real-world data study (2015–2022) in Spain

Pozo-Rosich,

Carmo,

Muñiz

et al. 2024

BMC Neurol

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“…The direct costs represented 32.0% of the total burden (344 million euros), 39.2% being for primary care visits, 28.7% for specialist visits, 20.5% for emergency room visits and a further 11.7% for migraine-specific prescription drugs. Similar results have been reported by Darbà and Marsà [ 21 ] in a recent study based on data from 2011 to 2016. These authors also found that headache disorders summed a total annual cost of 10,716,086 euros and migraine alone represented 7,302,718 euros of the total annual cost.…”

Section: Introductionsupporting

confidence: 92%

Prevalence of Migraine in General Spanish Population; Factors Related and Use of Health Resources

Salazar

Berrocal

Failde

2021

IJERPH

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Migraine is a common neurological disorder considered the second most disabling condition worldwide. Its prevalence ranges from 2.6% to 21.7% in population studies. This study aimed to know the prevalence of diagnosed and undiagnosed migraine in the general Spanish adult population, their health care use, and factors related. A descriptive cross-sectional study was undertaken with 23,089 individuals >15 years from the 2017 Spanish National Health Survey. Three groups were defined: people diagnosed with migraine (DM), people reporting undiagnosed migraine (UM) and people without migraine. Sociodemographic, clinical and use of health resources data were collected. The scales Duke Social Support Index (DSSI) and General Health Questionnaire (GHQ-12) were used. Prevalence of DM and UM were determined with 95% confidence intervals. To determine the factors associated with DM and UM, a multinomial logistic regression model was used. The prevalence of DM was 8.6% (95%CI: 8.2–9), and UM, 0.9% (95%CI: 0.8–1). People with DM more frequently visited healthcare professionals (47.8%), required more supplementary tests (86.8), had a higher percentage of hospitalization (11.3%), and used emergency services (45.1%). Women had nearly three times the risk of DM and UM. Worse mental health was a risk factor for UM (OR = 1.20) and DM (OR = 1.18). The greater the work stress, the greater the risk of DM (OR = 1.12). An adequate monitoring and management of migraine in people with these characteristics could contribute to improving their quality of life and reducing costs in the system.

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“…De acuerdo con un estudio recientemente publicado, en Europa estima una prevalencia global anual de un 38% de la población 2 , aumentando esta tasa de prevalencia hasta el 79% si consideramos cualquier tipo de dolor de cabeza 2 . Además, las tasas de prevalencia de ambos tipos de dolor de cabeza, se han duplicado desde 2011 3 . Casi todas las personas experimentan o experimentarán un dolor de cabeza en algún momento de sus vidas 4 .…”

Section: Introductionunclassified

“…Casi todas las personas experimentan o experimentarán un dolor de cabeza en algún momento de sus vidas 4 . En España, según un estudio con datos retrospectivos los costes médicos directos atribuibles al dolor de cabeza (de los cuales la migraña fue responsable del 50% de las hospitalizaciones, y el TTH de 14,47%) ascendieron a más de 10 millones de € anuales 3 . Las mujeres se ven más afectadas por este tipo de dolor de cabeza que los hombres, tanto en atención primaria (un 71,9% de mujeres), como hospitalaria (69,6%) 3 .…”

Section: Introductionunclassified