Burden of migraine and unmet needs from the patients' perspective: a survey across 11 specialized headache clinics in Korea

Abstract

Background: Migraine is a neurological, primary headache disorder affecting more than 1 billion people worldwide, with a multi-faceted burden that can significantly impact the everyday life of a patient, both during and between attacks. However, studies on patient awareness, burden, and clinical management of migraine in Korea are limited and outdated. The aim of this study was to comprehensively investigate the current difficulties and unmet needs that Korean patients with migraine encounter from their perspective.

Methods: A total of 207 patients with episodic or chronic migraine aged between 15 and 76 years, completed a survey designed to cover the following topics: diagnosis, understanding of the disease, treatment experience, disability, and quality of life. Patients were recruited by their neurologists from 11 specialized headache clinics in Korea and completed the survey between 22 July and 19 August 2019. Validated scales such as the Migraine Disability Assessment (MIDAS) questionnaire and Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQv2.1) were used to assess levels of disability and quality of life, respectively, in patients.

Results: On average, it took 10.1 years from onset of symptoms to diagnosis and a mean of 3.9 hospitals were visited for treatment prior to the patient's current hospital. There was a lack of understanding among respondents about migraine, with 55.6% believing that unilateral headache is a unique feature of migraine compared with other headache disorders. On average, high levels of disability and poor quality of life were reported by patients, as assessed by MIDAS and MSQv2.1, respectively, but only 23.7% had regularly taken preventive medication in the past. Overall satisfaction with previous doctor-patient relationships was reported by 29.5% of respondents, and satisfaction with preventive and acute medications by only 40.8% and 27.1% of the respondents, respectively.

Conclusion: Korean patients with migraine experience significant disability and reduced quality of life as a result of the disease and have clear unmet needs in terms of diagnosis, understanding of the disease, and disease management including treatment.

Keywords: Burden; Diagnosis; Disability; Korea; MIDAS; MSQv2.1; Migraine; Patient survey; Treatment.

Fig. 1

Knowledge about migraine. Results for knowledge of migraine are presented for each age group and for overall respondents, the latter inclusive of all age groups. Results are presented as percentage of respondents. N = Number of patients

Fig. 2

Migraine-related disability, quality of life, and pain severity. Results for MIDAS, MSQ total, MSQ RR, and pain severity are presented for each age group and for overall respondents, the latter inclusive of all age groups. Results are presented as mean score (SE). MIDAS = Migraine Disability Assessment; MSQ = Migraine-Specific Quality of Life Questionnaire; RR = Role Function-Restrictive; N = Number of patients; SE = Standard Error

Fig. 3

Past experience with preventive medication for migraine. Results for (a) prior regular use of preventive medication, (b) satisfaction with preventive medication, burden of cost, and withdrawal due to side effects, and (c) side effects experienced by those who withdrew are presented for each age group (and MIDAS grade group in (A)) and for overall respondents, the latter inclusive of all age groups. Results are presented as mean percentage of respondents. MIDAS = Migraine Disability Assessment; GI = Gastro-intestinal; N = Number of patients. * Respondents who did not take preventive medication regularly only took it when they were experiencing a headache. Those who took preventive medication regularly did so even in the absence of a headache