Prevalence, burden, and clinical management of migraine in China, Japan, and South Korea: a comprehensive review of the literature

DOI: https://doi.org/10.1186/s10194- 019- 1062- 4

Abstract-Summary The objective of this review was to determine the unmet needs for migraine in East Asian adults and children.

Studies reporting the prevalence, humanistic and economic burden, and clinical management of migraine in China (including Hong Kong and Taiwan), Japan, and South Korea were included.

The 1-year prevalence of migraine (IHS criteria) among adults ranged from 6.0%

to 14.3%.

For children, prevalence of migraine increased with age. Information on the economic burden and clinical management of migraine was

limited, particularly for children.

When reported, migraine was significantly associated with high levels of disabil-

ity and negative effects on quality of life.

Of individuals with migraine from China, 52.9% to 68.6% had consulted a physi- cian previously, 37.2% to 52.7% diagnosed with headache had not been diagnosed with migraine previously, and 13.5% to 18% had been diagnosed with migraine previously.

Of individuals with migraine from Japan, 59.4–71.8% had never consulted a physician previously, 1.3–7.3% regularly consulted physicians for their headache, and only 11.6% of individuals with migraine were aware that they had migraine.

This review suggests that there are unmet needs for migraine in terms of suffi- cient and appropriate diagnosis, and better management and therapies for treatment of migraine in East Asia.

More recent, population-based studies assessing disease burden and clinical management of migraine are needed to confirm unmet needs for migraine across East Asia.

Extended: The objective of this comprehensive literature review of the evidence related to the prevalence, burden, and clinical management of migraine in East Asia (China, Japan, and South Korea) was to determine the unmet needs for migraine in both adults and children.

Because of the wide variation in study types, populations, and analysis methods,

it was not possible to compare findings between countries.

Introduction These reviews were focused on the prevalence of chronic migraine and chronic daily headache, and on headache disorders across multiple countries, with little information on migraine-related burden.

1.1

Epidemiology

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The objective of this comprehensive literature review of the evidence related to the prevalence, burden, and clinical management of migraine in East Asia (China, Japan, and South Korea) was to determine the unmet needs for migraine in both adults and children.

The key outcomes were prevalence, disease burden (humanistic or economic), and clinical management of migraine, including health care utilization and clinical practice patterns.

Materials and methods All studies were to include at least one of the following outcomes of migraine: prevalence, humanistic burden (all reported measures of health-related quality of life [HRQoL], migraine-related disability, and measures of the impact of migraine on aspects of daily living and social activities), economic burden (work-related pro- ductivity, direct and indirect medical costs), and clinical management (health care utilization, clinical practice patterns).

Inclusion of each potential publication was then confirmed after a review of the full text to identify publications reporting one or more of the following eligible outcomes: prevalence of migraine, humanistic burden, economic burden, and clini- cal management as described above.

The data extracted included study characteristics, population characteristics, cri- teria for migraine diagnosis, prevalence of migraine, outcomes measuring or describing migraine burden (humanistic, work-related productivity, indirect and direct medical costs), health care utilization, and clinical practice patterns.

Results Mean MIDAS scores from studies conducted in China and Japan [1–3] indicated severe levels of disability among many patients attending headache clinics for migraine.

Of the six studies retrieved, three provided an estimate of the direct or indirect medical costs of migraine or of costs associated with migraine work-related disabil- ity [4–6], with all suggesting that the economic impact of migraine was substantial at the time the studies were conducted.

Findings from a population-based study conducted in Taiwan in 1997–1998 esti- mated that migraine was responsible for an annual cost of NTD 4873 (USD 149) per person and a total annual cost of NTD 4.6 billion (USD 140 million) per year due to lost work days.

Findings from one population-based study showed that only 24.4% of individu- als with migraine had consulted a physician for headache, 64.3% were taking medi- cation for their headache and, of these, most (92.8%) were using OTC medication [7].

Discussion Findings from the population-based studies retrieved in our literature review showed that migraine prevalence among adults in East Asia ranged from 6.0% to 14.3% in non-elderly adults, which is consistent with worldwide estimates of migraine preva- lence [8] and a previous study conducted among Asia-Pacific countries up until 2013 [9].

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1 Public Health

Consistent with worldwide studies on migraine disability [8], the peak preva-

lence of migraine in East Asia was among adult women aged 30 to 49 years.

Findings from the International Burden of Migraine Study [10], which surveyed 8726 individuals from predominantly Caucasian populations with chronic or epi- sodic migraine, showed that approximately 50% reported moderate or significant levels of disability (MIDAS grade III or IV) and significantly negative effects on HRQoL for those with chronic migraine.

Consistent with studies in predominantly Caucasian populations [10, 11], the humanistic burden of migraine in East Asia from the available studies has suggested that there are unmet needs for improvements in diagnosis, management, and thera- pies for treatment of migraine across East Asia.

Conclusion Combined with the high prevalence of migraine across all countries included in this review, the significant levels of humanistic burden among the available studies sug- gest that there are substantial unmet needs for migraine with regard to appropriate diagnosis, and better management of and therapies for treatment of migraine across East Asia.

Acknowledgement A machine generated summary based on the work of Takeshima, Takao; Wan, Qi; Zhang, Yanlei; Komori, Mika; Stretton, Serina; Rajan, Narayan; Treuer, Tamas; Ueda, Kaname. 2019 in The Journal of Headache and Pain.

Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019