Burden of Migraine in Japan: Results of the ObserVational Survey of the Epidemiology, tReatment, and Care Of MigrainE (OVERCOME [Japan]) Study

Abstract

Introduction: The ObserVational survey of the Epidemiology, tReatment, and Care Of MigrainE study in Japan (OVERCOME [Japan]) assessed the impact and burden of migraine in Japan.

Methods: OVERCOME (Japan) was a cross-sectional, observational, population-based web survey of Japanese people with migraine conducted between July and September 2020. The burden and impact of migraine were assessed using the Migraine Disability Assessment (MIDAS), Migraine-Specific Quality-of-Life Questionnaire (MSQ), Migraine Interictal Burden Scale (MIBS-4), and Work Productivity and Activity Impairment-Migraine scale. Results were stratified by average number of monthly headache days (0-3, 4-7, 8-14, ≥ 15).

Results: In total, 17,071 Japanese people with migraine completed the survey. Of these, 14,033 (82.2%) met International Classification of Headache Disorders, 3rd edition criteria for migraine and 9667 (56.6%) reported a physician diagnosis of migraine. Overall, 20.7% of respondents experienced moderate-to-severe disability (MIDAS). Moderate-to-severe interictal burden (MIBS-4) was experienced by 41.5% of respondents. MSQ scores in all domains were lowest in respondents with the most frequent headaches (≥ 15 monthly headache days) and highest in those with the lowest frequency headaches (≤ 3 monthly headache days), indicating poorer quality of life in those with more frequent headaches. Work time missed due to migraine (absenteeism) increased with increasing headache frequency, from 3.8 to 6.2%; presenteeism affected 29.8-49.9% of work time. Although migraine burden was greatest in people with the most frequent headaches, those with the lowest headache frequency still experienced substantial disability, interictal burden, and impacts on productivity and quality of life. There was also substantial unmet need for migraine care: 36.5% of respondents had ever hesitated to seek medical care for their headaches, and 89.8% had never used preventive medication.

Conclusion: In Japan, the burden of migraine and barriers to migraine care are substantial. Improving patient awareness and healthcare provider vigilance may help improve patient outcomes.

Keywords: Drug therapy; Headache disorders; Japan; Migraine burden; Migraine disorders; Quality of life; Work productivity.

Fig. 1

a Migraine-related disability (MIDAS grade) in each of the monthly headache days groups. b HRQoL scores (MSQ domain scores) in each of the monthly headache days groups. CM, chronic migraine; HFEM, high-frequency episodic migraine; HRQoL, health-related quality of life; LFEM, low-frequency episodic migraine; MFEM, moderate-frequency episodic migraine; MIDAS, Migraine Disability Assessment; MSQ, Migraine-Specific Quality-of-Life Questionnaire

Fig. 2

Interictal burden across monthly headache days groups. Interictal burden categories from the MIBS-4 are none (score of 0), mild (score of 1–2), moderate (score of 3–4), and severe (score ≥ 5). CM, chronic migraine; HFEM, high-frequency episodic migraine; LFEM, low-frequency episodic migraine; MFEM, moderate-frequency episodic migraine; MIBS-4, Migraine Interictal Burden Scale

Fig. 3

WPAI-M scores across monthly headache days groups. All respondents answered the WPAI-M total activity impairment questions, but only those who were full-time, part-time, or self-employed provided data for absenteeism, presenteeism, and overall work impairment. The numbers of respondents in each monthly headache days category for each of the WPAI-M subscales were: absenteeism LFEM n = 7295, MFEM n = 1854, HFEM n = 1049, CM n = 792; presenteeism LFEM n = 7261, MFEM n = 1848, HFEM n = 1043, CM n = 784; total work impairment LFEM n = 7295, MFEM n = 1854, HFEM n = 1049, CM n = 792; total activity impairment LFEM n = 11,498, MFEM n = 2714, HFEM n = 1608, CM n = 1251. CM, chronic migraine; HFEM, high-frequency episodic migraine; LFEM, low-frequency episodic migraine; MFEM, moderate-frequency episodic migraine; WPAI-M, Work Productivity and Activity Impairment-Migraine

Fig. 4

Hesitation in seeking care for migraine across monthly headache days groups: a proportion of respondents who had and had not hesitated to seek care for migraine from their doctor or healthcare provider and b frequency of the top three reasons for not seeking care for migraine or severe headache. CM, chronic migraine; HFEM, high-frequency episodic migraine; LFEM, low-frequency episodic migraine; MFEM, moderate-frequency episodic migraine

Fig. 5

Use of preventive migraine medication across monthly headache days groups: a the number of preventive medications^a ever used by respondents and b frequency of the top five reasons for not having ever used preventive medication. ^aRespondents who did not answer this question were assumed not to have used preventives, i.e., were included in the “0 preventive medications used” group. CM, chronic migraine; HFEM, high-frequency episodic migraine; LFEM, low-frequency episodic migraine; MFEM, moderate-frequency episodic migraine