Migraine Sufferers and MyVoice

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RESEARCH UPDATE

Frequent migraine sufferers who have not responded to preventive treatment experience a substantial burden of disease which often extends beyond the headache phase, according to a study published in the Journal of Headache Pain.¹ The study is the largest global survey of its kind.

“The size and granularity of this study have created a rich data source to describe the impact of migraine in this economically active population, with personal, social, and professional commitments and high healthcare use in unprecedented detail,” wrote first author Paolo Martelletti, MD, of the European Headache Federation (Rome, Italy), and colleagues.

Studies looking at the burden of disease in migraine have found that it ranks sixth among causes of years lost due to disability.² However, these studies have not focused on frequent migraine sufferers, for whom unmet needs are high.

To look more specifically at this population, researchers conducted a cross-sectional study called My Migraine Voice in 31 countries globally. It included 11,266 individuals with at least four migraine days per month despite having tried at least one preventive treatment. Respondents included: 1689 from North America, 1438 from South America, 6156 from Europe, 1111 from the Middle East and Africa, and 872 from Asia-Pacific region. Seventy-five percent of respondents were female.

In the study, researchers used an online survey of adults with four or more migraine days experienced at least three months before the survey. Ninety-percent of participants had used preventive migraine treatment and 80% had experienced one or more treatment failure.

The survey consisted of 88 questions that evaluated sociodemographics, health history, health-related quality of life, impact of migraine on physical activities, treatment patterns and experiences, and healthcare utilization. Where appropriate, questions were country-specific.

Results showed that respondents understandably reported the highest amount of impairment during migraine attacks. However, they also reported impairment that extended beyond the headache phase.

Eighty-five reported at least one negative aspect of migraine. Most frequently, they reported being misunderstood by others (48%), followed by depression (41%), hating their own life (39%), feeling helpless (39%) and feeling that migraine controls/dictates their life (39%).

Migraine had a negative impact across multiple domains of life, with 87% reporting that it impacted professional, private and social activities. Respondents reported negative effects such as missed birthdays or weddings (52%), negative effects on sex life (49%), and feeling guilty about the impact of migraine on family life (44%).

Migraine also had a negative impact on daily functioning. Forty-nine percent reported feeling limited in daily activities, and 52% reported overall impaired work productivity due to absenteeism or presenteeism. Respondents reported an average of 4.6 missed work days per month due to migraine. Only 9% reported receiving disability due to their migraines.

Migraine sufferers also reported a high degree of health utilization. Thirty-eight percent had visited an emergency department in the past 12 months and 23% reported hospitalization for migraine. Twenty percent reported taking opioids for acute treatment.

Interestingly, 57% of respondents acknowledged some positive aspect of migraine, mainly related to resilience such as learning to cope and becoming a stronger person.

“The greater resilience and strength brought on by coping with migraine suggests that if future treatments could address their existing unmet needs, these individuals with migraine will be able to maximize their contribution to society,” the authors concluded.

The authors mentioned several limitations. The study could not include participants without internet access. All data was self-reported and researchers did not clinically confirm migraine diagnosis.

Take Home Points

• MyVoice was the largest global survey of the burden of migraine in individuals with frequent attacks and without response to preventive treatment

• Respondents reported substantial burden of disease that extends beyond the headache phase

• 87% reported negative impacts on professional, private and social activities

• 85% reported at least one negative impact of migraine, most frequently related to being misunderstood

• A little over half reported some positive aspects, most frequently related to resilience

References:

1. Martelletti P, Schwedt TJ, Lanteri-Minet M, et al. My Migraine Voice survey: a global study of disease burden among individuals with migraine for whom preventive treatments have failed. J Headache Pain. 2018;19:115.

2. World Health Organization. Headache disorders. http://www.who.int/en/news-room/fact-sheets/detail/headache-disorders. Accessed December 9, 2018.