The Economic Cost of Patients With Migraine Headache Referred to Specialist Clinics

Osumili, Beatrice; McCrone, Paul; Cousins, Sian; Ridsdale, Leone

doi:10.1111/head.13210

Cited by 26 publications

(16 citation statements)

References 24 publications

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“…As the world's second leading cause of years lived with disability, 1 migraine constitutes a significant public health problem associated with substantial costs related to health care utilization, [2][3][4][5] loss of productive time, [3][4][5][6] and impaired social functioning. [6][7][8][9][10] Despite this, there is still an incomplete understanding of both the clinical manifestations of migraine and the underlying disease biology.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary Data

Vives‐Mestres

Casanova²,

Buse

et al. 2020

Headache

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Objectives To describe patterns of perceived stress across stages of the migraine cycle, within and between individuals and migraine episodes as defined for this study. Methods Individuals with migraine aged ≥18 years, who were registered to use the digital health platform N1‐HeadacheTM, and completed 90 days of daily data entry regarding migraine, headache symptoms, and lifestyle factors were eligible for inclusion. Perceived stress was rated once a day at the participant’s chosen time with a single question, “How stressed have you felt today?” with response options graded on a 0‐10 scale. Days were categorized into phases of the migraine cycle: Ppre = pre‐migraine headache (the 2 days prior to the first day with migraine headache), P0 = migraine headache days, Ppost = post‐migraine headache (the 2 days following the last migraine day with migraine headache), and Pi = interictal days (all other days). Episodes, defined as discrete occurrences of migraine with days in all 4 phases, were eligible if there was at least 1 reported daily perceived stress value in each phase. Individuals with ≥5 valid episodes, and ≥75% compliance (tracking 90 days in 120 calendar days or less) were eligible for inclusion in the analysis. Results Data from 351 participants and 2115 episodes were included in this analysis. Eighty‐six percent of the sample (302/351) were female. The mean number of migraine days per month was 6.1 (range 2‐13, standard deviation = 2.3) and the mean number of episodes was 6.0 (range 5‐10, standard deviation = 1.0) over the 90‐day period. Only 8 (8/351, 2.3%) participants had chronic migraine (defined as 15 or more headache days per month with at least 8 days meeting criteria for migraine). Cluster analysis revealed 3 common patterns of perceived stress variation across the migraine cycle. For cluster 1, the “let down” pattern, perceived stress in the interictal phase (Pi) falls in the pre‐headache phase (Ppre) and then decreases more in the migraine phase (P0) relative to Pi. For cluster 2, the “flat” pattern, perceived stress is relatively unchanging throughout the migraine cycle. For cluster 3, the “stress as a trigger/symptom” pattern, perceived stress in Ppre increases relative to Pi, and increases further in P0 relative to Pi. Episodes were distributed across clusters as follows: cluster 1: 354/2115, 16.7%; cluster 2: 1253/2115, 59.2%, and cluster 3: 508/2115, 24.0%. Twelve participants (12/351, 3.4%) had more than 50% of their episodes fall into cluster 1, 216 participants (216/351, 61.5%) had more than 50% of their episodes fall into cluster 2, and 25 participants (25/351, 7.1%) had more than 50% of their episodes fall into cluster 3. There were 40 participants with ≥90% of their episodes in cluster 2, with no participants having ≥90% of their episodes in cluster 1 or 3. Conclusions On an aggregate level, perceived stress peaks during the pain phase of the migraine cycle. However, on an individual and episode basis, there are 3 dominant patterns of perceived stress variation across the migraine cycl...

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Section: Introductionmentioning

confidence: 99%

Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary Data

Vives‐Mestres

Casanova²,

Buse

et al. 2020

Headache

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“…Chronic pain has a significant impact on both individuals and society. The costs of chronic musculoskeletal pain can reach 0,5% of the whole GDP based on a study from Chile, while the economic cost of migraine can be as high as £835 million annually in the UK [3,4].…”

mentioning

confidence: 99%

Chronic Pain Hurts the Brain: The Pain Physician’s Perspective

Fehér

Delia

Rodriguez-Saldana³

et al. 2020

Behavioural Neurology

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“…Primary headaches are the most prevalent neurological disorders and the main neurological cause of years lived with disability, particularly in the middle age group under 50 years old adults, in which migraine is the first cause of disability [1]. They represent also one of the main neurological disorders regarding economical costs [2], and symptomatic treatment accounts for the biggest part of them [3].…”

Section: Introductionmentioning

confidence: 99%

A PRISMA-compliant systematic review of the endpoints employed to evaluate symptomatic treatments for primary headaches

et al. 2018

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BackgroundPrimary headache are prevalent and debilitating disorders. Acute pain cessation is one of the key points in their treatment. Many drugs have been studied but the design of the trials is not usually homogeneous. Efficacy of the trial is determined depending on the selected primary endpoint and usually other different outcomes are measured. We aim to critically appraise which were the employed outcomes through a systematic review.MethodsWe conducted a systematic review of literature focusing on studies on primary headache evaluating acute relief of pain, following the PRISMA guideline. The study population included patients participating in a controlled study about symptomatic treatment. The comparator could be placebo or the standard of care. The collected information was the primary outcome of the study and all secondary outcomes. We evaluated the studied drug, the year of publication and the type of journal. We performed a search and we screened all the potential papers and reviewed them considering inclusion/exclusion criteria.ResultsThe search showed 4288 clinical trials that were screened and 794 full articles were assessed for eligibility for a final inclusion of 495 papers. The studies were published in headache specific journals (58%), general journals (21.6%) and neuroscience journals (20.4%).Migraine was the most studied headache, in 87.8% studies, followed by tension type headache in 4.7%. Regarding the most evaluated drug, triptans represented 68.6% of all studies, followed by non-steroidal anti-inflammatories (25.1%). Only 4.6% of the papers evaluated ergots and 1.6% analyzed opioids.The most frequent primary endpoint was the relief of the headache at a determinate moment, in 54.1%. Primary endpoint was evaluated at 2-h in 69.9% of the studies. Concerning other endpoints, tolerance was the most frequently addressed (83%), followed by headache relief (71.1%), improvement of other symptoms (62.5%) and presence of relapse (54%). The number of secondary endpoints increased from 4.2 (SD = 2.0) before 1991 to 6.39 after 2013 (p = 0.001).ConclusionHeadache relief has been the most employed primary endpoint but headache disappearance starts to be firmly considered. The number of secondary endpoints increases over time and other outcomes such as disability, quality of life and patients’ preference are receiving attention.

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The Economic Cost of Patients With Migraine Headache Referred to Specialist Clinics

Abstract: Costs of headache are high, and increase with severity of symptoms. The annual cost to the country for those referred to specialists is estimated at £835 million.

Cited by 26 publications

References 24 publications

Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary Data

Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary Data

Chronic Pain Hurts the Brain: The Pain Physician’s Perspective

A PRISMA-compliant systematic review of the endpoints employed to evaluate symptomatic treatments for primary headaches

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