Prevalence, disability, and economic impact of migraine in Spain: a nationwide population-based study

Abstract

Background: This study updates data on migraine prevalence in Spain, examining regional variations, healthcare resource utilization (HCRU), and patient-reported outcomes (PROs).

Methods: Cross sectional study using data from the 2022 National Health and Wellness Survey, an online survey of Spanish residents aged 18 or older. Respondents diagnosed with migraine by a physician and who reported at least one migraine in the past year were considered active migraine cases.

Results: The study included 7,002 respondents, 930 of whom had physician-diagnosed active migraine. The estimated one-year prevalence of migraine in Spain was 13.1% (95% confidence interval [CI] 12.8-13.4%), with higher rates in females (17.7%, 95% CI 17.2-18.3%) than in males (8.2%, 95% CI 7.8-8.6%). Migraine prevalence varied across Spain's regions, ranging from 8.1% (95% CI 5.2-11.0%) in Navarre to 19.1% in Cantabria (95% CI 15.6-22.6%). Prevalence was the highest among individuals earning below the median income (14.7%, 95% CI 14.1-15.4%). In the preceding month, 75.3% of patients experienced < 4 migraine days, 15.3% 4-9 migraine days, 4.1% 10-14 migraine days, and 5.3% ≥15 migraine days. Severe disability from migraine was reported by 20.4% of respondents. One in ten people reported using a preventive treatment for migraine. The mean SF-12 scores for mental and physical health were 37.8 and 42.1, respectively, both below the general population norm of 50. The mean EQ-5D summary score was 0.8, indicating reduced quality of life and the PHQ-9 detected severe depressive symptoms in 8.8% of individuals. Work productivity was affected by migraine, with a mean work productivity loss of 35.8%. HCRU in the preceding 6 months was high, with 68.4% having visited at least once a general practitioner, 14.2% a neurologist, 45.6% the emergency room, and 11.8% being hospitalized. The annual cost per person with migraine was estimated at €6,704, primarily driven by indirect costs related to productivity loss.

Conclusions: Migraine prevalence remains high in Spain, causing a substantial burden and representing a major public health problem. Despite the availability of effective treatments, their usage is limited. Improving migraine management should be prioritized to enhance health outcomes and reduce societal burden.

Keywords: Burden; Cost of illness; Depression; Epidemiology; Headache disorders; Migraine.

Fig. 1

One-year prevalence rates of self-reported physician-diagnosed active migraine by region (95% Confidence Interval)

Fig. 2

One-year prevalence rates of self-reported physician-diagnosed active migraine by age groups and sex (95% Confidence Interval)

Fig. 3

One-year prevalence rates of self-reported physician-diagnosed active migraine by socioeconomic status (95% Confidence Interval)

Fig. 4

One-year prevalence rates of self-reported physician-diagnosed active migraine by Charlson comorbidity index score (95% Confidence Interval)

Fig. 5

Number of days with migraine per month reported by people with physician-diagnosed active migraine (% of respondents)

Fig. 6

Current migraine treatments reported by people with physician-diagnosed active migraine (% of respondents)

Fig. 7

Direct and indirect annual cost of migraine per person with self-reported physician-diagnosed active diagnosed migraine (€)