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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Transformed Migraine
Imposes Substantial Economic Burden |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— Patients with transformed migraine use
significantly more healthcare resources and miss significantly
more days from work compared with patients with migraine, which
emphasizes the need to prevent migraine progression, according
to a study presented on April 17 at the annual meeting of the
American Academy of Neurology.
Transformed migraine was associated with more than a threefold
increase in visits to primary care providers and a fivefold
increase in visits with neurologists, reported Julie Munakata, a
consultant with IMS Consulting in Falls Church, Va. Absenteeism
from school or work was seven times greater, and reduced
productivity was five times more common in patients with
transformed migraine versus migraine.
“These data underscore a need to address traditional goals of
migraine treatment of relieving pain and restoring patient
function and preventing migraine progression,” Munakata and her
colleagues concluded.
Emerging evidence suggests migraine progresses in some instances
to transformed migraine, which is the most common subtype of
chronic daily headache. Transformed migraine also is one of the
most challenging headache disorders to treat, according to
Munakata.
Little information is available on the economic impact of
transformed migraine. To add to the knowledge base, Munakata and
colleagues reviewed data from the American Migraine Prevalence
and Prevention (AMPP) study, a longitudinal study of headache in
the United States. Started in 2004, AMPP has amassed data on
more than 120,000 U.S. households.
Of the 162,576 respondents to the initial AMPP survey, 30,721
were identified as headache-prone on the basis of answers to a
screening questionnaire. In 2005, AMPP researchers mailed a
60-item baseline questionnaire to 24,000 individuals in the
headache cohort. The questionnaire included detailed questions
about headache features, impairment, resource use, and loss of
productivity. The investigators received 16,577 completed
surveys.
In 2006, a follow-up questionnaire was mailed to 20,639
respondents to the screening and baseline questionnaires, and
14,544 completed and returned the 71-item headache survey. On
the basis of responses to this survey, investigators identified
all adults who met International Classification of Headache
Disorders criteria for migraine. From the migraine cohort,
investigators identified individuals with transformed migraine,
defined as migraine plus 15 or more headache days per month.
The current study included 7,437 survey respondents with
migraine and 359 with transformed migraine. Migraine
participants averaged three episodes in the previous and 19 in
the previous 12 months. In contrast, participants with
transformed migraine reported 15 migraine episodes in the
previous month and an average of 135 episodes over the previous
year (P<0.01 vs. the migraine group).
With respect to resource utilization, every parameter assessed
demonstrated greater use by study participants with transformed
migraine. For most of the parameters, transformed migraine was
associated with a threefold to fivefold increased rate of
utilization, including pain clinic visits, emergency room
visits, and hospitalization, in addition to visits to primary
care and neurology providers.
Analysis of productivity loss by headache category revealed an
absenteeism rate of 56 days per 100 participants during the
previous 90 days versus 351 days per 100 participants with
transformed migraine. Moreover, days with headache-attributable
loss of productivity of 50% or more over the past 90 days
averaged 198 per 100 persons in the migraine group and 1,049 per
100 persons in participants with transformed migraine (P<0.01
for both comparisons). |
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