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. 2020 Nov 9;10(11):e038987.
doi: 10.1136/bmjopen-2020-038987.

Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey

Hisaka Igarashi  1 , Kaname Ueda  2 , Sungeun Jung  3 , Zhihong Cai  4 , Yirong Chen  5 , Tomomi Nakamura  4
Affiliations

Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey

Hisaka Igarashi et al. BMJ Open. .

Abstract

Objectives: To quantify the social burden among Japanese migraine patients in the context of currently available migraine treatments, by comparison with non-migraine controls, and comparison of migraine patients currently taking prescription medication versus not taking prescription medication.

Design: Cross-sectional analysis.

Setting: Data from the population-based online self-administered Japan National Health and Wellness Survey (NHWS) 2017.

Participants: Respondents to the NHWS (n=30 001) were ≥18 years. Migraine patients were respondents with self-reported experience and physician diagnosis of migraine. Non-migraine controls reported no migraine experience. Migraine patients were subgrouped into currently taking prescription medication for migraine (Rx) and currently not taking prescription medication (non-Rx).

Methods: One-way analysis of variance tests were performed to compare health-related quality of life (HRQoL), work productivity and activity impairment and healthcare resource utilisation between migraine patients and matched non-migraine controls selected by 1:1 propensity score matching. Generalised linear models were used to compare outcomes and migraine related characteristics between Rx and non-Rx.

Results: Compared with matched controls, migraine patients (n=1265) had significantly lower HRQoL in terms of lower Physical Component Summary (48.36 vs 51.29, p<0.001), Mental Component Summary (44.65 vs 48.31, p<0.001), Role/Social Component Summary (41.78 vs 46.18, p<0.001) and mean EuroQol 5-Dimension index (0.77 vs 0.86, p<0.001) scores. Migraine patients experienced significantly higher absenteeism (6.95% vs 3.07%, p<0.001), presenteeism (32.73% vs 18.94%, p<0.001), work productivity loss (34.82% vs 20.03%, p<0.001) and daily activity impairment (35.70% vs 22.04%, p<0.001) and visited healthcare professionals more often (8.38 vs 4.57, p<0.001) than controls. No significant differences in these outcomes were found when comparing Rx (n=587) and non-Rx (n=678) patients.

Conclusions: There is an unmet need for improved HRQoL and work productivity in Japanese migraine patients despite the currently available prescription medications, which are important factors to consider for future development of migraine therapies.

Keywords: health economics; migraine; public health.

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Conflict of interest statement

Competing interests: HI reports personal fees for consulting, lectures and speaker's honorarium from Pfizer, Eisai, Otsuka Pharmaceutical, Kyowa Kirin, Takeda Pharmaceutical, Amgen Astellas BioPharma, and Eli Lilly, outside the submitted work. KU, TK and ZC are full-time employees of Eli Lilly Japan KK. and share holders of Eli Lilly & Company. SJ and YC are full-time employees of Kantar, Health Division.

Figures

Figure 1
Figure 1
Respondent flow chart. NHWS, National Health and Wellness Survey; Rx, prescription medication.
Figure 2
Figure 2
Comparison of health outcomes between migraine patients and matched non-migraine respondents (A–C), and between migraine patients currently taking Rx and not currently taking Rx (D–F). (A–C) Migraine patients and matched non-migraine respondents: Bivariate analysis for comparison of health outcomes between migraine patients and matched non-migraine respondents. D–F: migraine patients currently taking prescription medication (RX) and migraine patients not currently taking RX: adjusted means from GLM analysis for comparison of health outcomes between migraine patients currently taking prescription medication (RX) and migraine patients not currently taking RX. EQ-5D, EuroQol-5 Dimension; ER, emergency room; HCRU, healthcare resource utilisation; HRQoL, health-related quality of life; MCS, Mental Component Summary; PCS, Physical Component Summary; RCS, Role/Social Component Summary; Rx, prescription medication; WPAI, work productivity and activity impairment.
Figure 3
Figure 3
Migraine-related symptoms. Non-Rx, patients currently not taking prescription medication; Rx, patients currently taking prescription medication.
See this image and copyright information in PMC

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