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Review
. 2022 Sep;50(9):3000605221126380.
doi: 10.1177/03000605221126380.

Epidemiology and treatment utilization for Canadian patients with migraine: a literature review

Erin B Graves  1 , Brittany R Gerber  1 , Patrick S Berrigan  1 , Eileen Shaw  1 , Tara M Cowling  1 , Marie-Pier Ladouceur  2 , Joanna K Bougie  2
Affiliations
Review

Epidemiology and treatment utilization for Canadian patients with migraine: a literature review

Erin B Graves et al. J Int Med Res. 2022 Sep.

Abstract

The objective of this narrative review was to identify real-world evidence regarding the burden of migraine in Canada. We conducted a literature search in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews for studies published between August 2010 and August 2020. Of the 3269 publications identified, 29 studies were included. Prevalence estimates varied widely across Canada, and mental health comorbidities were common. Individuals with migraine have a lower quality of life, detrimental impact on workforce productivity, and higher rates of health care resource utilization (HCRU), with HCRU and costs highest among those with chronic migraine. We found inconsistencies in care, including underutilization of medications such as triptans, and varied utilization of over-the-counter and prescription medications. Increased medication use was identified among those with chronic migraine, and only a small number of patients used migraine preventive medications. The burden of migraine in Canada is substantial. Reduced quality of life and workforce productivity, increased HCRU and costs, and underutilization of triptans and migraine preventive medications highlight an important need for more effective management of individuals with migraine.

Keywords: Canada; Chronic migraine; episodic migraine; headache; real-world evidence; treatment pattern; unmet need.

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Conflict of interest statement

Declaration of conflicting interest: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Graves E, Gerber B, Berrigan P, Shaw E, and Cowling T are employed by Medlior Health Outcomes Research Ltd., which received funding for the study from Lundbeck Canada Inc. Bougie J and Ladouceur MP are employed by Lundbeck Canada Inc., who funded this study.

Figures

Figure 1.
Figure 1.
Study inclusion diagram. Cochrane DSR, Cochrane Database of Systematic Reviews.
Figure 2.
Figure 2.
Geographic visualization of included studies. Note: Several studies include more than one province. AB, Alberta; BC, British Columbia; MB, Manitoba; NB, New Brunswick; NFL, Newfoundland and Labrador; NS, Nova Scotia; NU, Nunavut; NWT, Northwest Territories; ON, Ontario; PEI, Prince Edward Island; QC, Quebec; SK, Saskatchewan; YT, Yukon.
Figure 3.
Figure 3.
Frequency of mental health comorbidities reported in the included studies (n = 22). Note: This figure presents a broad look at the number of studies in this review reporting mental health comorbidities across a broad spectrum of general and specific populations. Whereas it is difficult to draw conclusions from this given the heterogeneous nature of the included studies, the figure does provide a high-level picture of the relative co-occurrence of migraine and different mental health comorbidities in the Canadian literature involving real-world evidence.
Figure 4.
Figure 4.
Percentage of patients in each disability category according to MIDAS scores reported in the included studies (n = 3) for patients with chronic or episodic migraine. Note: All three studies reported results for both chronic and episodic migraine. MIDAS, migraine disability assessment.
Figure 5.
Figure 5.
Medication use reported in Stoke et al. 2019.
See this image and copyright information in PMC

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