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. 2018 Sep 10;19(1):82.
doi: 10.1186/s10194-018-0907-6.

Patients' perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom

Pamela Vo  1 , Juanzhi Fang  2 , Aikaterini Bilitou  3 , Annik K Laflamme  1 , Shaloo Gupta  4
Affiliations

Patients' perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom

Pamela Vo et al. J Headache Pain. .

Abstract

Background: Migraine is a distinct neurological disease that imposes a significant burden on patients, society, and the healthcare system. This study aimed to characterize the incremental burden of migraine in individuals who suffer from ≥4 monthly headache days (MHDs) by examining health-related quality of life (HRQoL), impairments to work productivity and daily activities, and healthcare resource utilization (HRU) in the EU5 (France, Germany, Italy, Spain, United Kingdom).

Methods: This retrospective cross-sectional study used data from the 2016 National Health and Wellness Survey (NHWS; N = 80,600). Short-Form 36-Item Health Survey, version 2 (SF-36v2) physical and mental component summary scores (PCS and MCS), Short-form-6D (SF-6D), and EuroQoL (EQ-5D), impairments to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire (WPAI), and HRU were compared between migraine respondents suffering from ≥4 MHDs (n = 218) and non-migraine controls (n = 218) by propensity score matching using sociodemographic characteristics. Chi-square, T-tests, and Mann-Whitney tests were performed to determine significant differences between the groups after propensity score matching.

Results: HRQoL was lower in migraine individuals suffering from ≥4 MHDs compared with non-migraine controls, with reduced SF-36v2 PCS (46.00 vs 50.51) and MCS (37.69 vs 44.82), SF-6D health state utility score (0.62 vs 0.71), and EQ-5D score (0.68 vs 0.81) (for all, p < 0.001). Respondents with migraine suffering from ≥4 MHDs also reported higher levels of absenteeism from work (14.43% vs 9.46%; p = 0.001), presenteeism (35.52% vs 20.97%), overall work impairment (38.70% vs 23.27%), and activity impairment (44.17% vs 27.75%) than non-migraine controls (for all, p < 0.001). Additionally, HRU was significantly higher for individuals with ≥4 MHDs compared to their matched controls. Consistently, migraine subgroups (4-7 MHDs, 8-14 MHDs and CM) had lower HRQoL, greater overall work and activity impairment, and higher HRU compared to non-migraine controls.

Conclusions: Migraine of ≥4 MHDs was associated with poorer HRQoL, greater work productivity loss, and higher HRU compared with non-migraine controls. The findings of the study suggest that an unmet need exists among individuals suffering from ≥4 MHDs in the EU5 suggesting the need for effective prophylactic treatments to lessen the humanistic and economic burden of migraine.

Keywords: Activity impairment; Burden; Health-related quality of life; Healthcare resource use; Migraine; Work impairment.

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Conflict of interest statement

Ethics approval and consent to participate

The NHWS received approval from the Pearl Institutional Review Board. All NHWS respondents provided informed consent prior to participating.

Consent for publication

All authors consent to publish the results presented here.

Competing interests

SG is an employee of Kantar Health, which conducted the NHWS and received funding to analyze and develop the manuscript from Novartis. PV, JF and AKL are employees of Novartis, which funded the current study. AB was a Novartis employee at the time of the study completion and manuscript preparation.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Selection of study population CM, chronic migraine; EM: episodic migraine; EU5, France, Germany, Italy, Spain, and the United Kingdom; NHWS, National Health Wellness Survey; n, the total number of respondents across the EU5.
Fig. 2
Fig. 2
MCS and PCS scores of SF-36v2 of migraine subgroups vs propensity score matched non-migraine controls T-tests were used for analysis. CM, chronic migraine; EM, episodic migraine; MCS, mental component summary; MHD, monthly headache day; PCS, physical component summary.
Fig. 3
Fig. 3
SF-6D health utility score and EQ-5D Index of migraine subgroups vs propensity score matched non-migraine controls T-tests were used for analysis. CM, chronic migraine; EM, episodic migraine; EQ-5D, EuroQol-5D; MHD, monthly headache day; QoL, quality of life.
Fig. 4
Fig. 4
Work productivity loss in migraine subgroups vs propensity score matched non-migraine controls by the WPAI metrics Mann-Whitney tests were used for analysis. CM, chronic migraine; EM, episodic migraine; MHD, monthly headache day; WPAI, work productivity and activity impairment.
Fig. 5
Fig. 5
Total work productivity and activity impairment in migraine subgroups vs propensity score matched non-migraine controls Mann-Whitney tests were used for analysis. CM, chronic migraine; EM, episodic migraine; MHD, monthly headache day.
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