Burden of Migraine in Europe Using Self-Reported Digital Diary Data from the Migraine Buddy© Application

DOI: https://doi.org/10.1007/s40120- 018- 0113- 0

Abstract-Summary This study described the burden of migraine as reported by individuals with migraine in the real world using a mobile application.

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Data were analyzed descriptively for the most recent 28-day period reported by users (n = 3900) during the study period (June 2015–July 2016) who were randomly selected on the basis of data completeness (completion rates > 70%) and stratified by migraine headache days/month: 4–7 episodic migraine (EM; n = 1500), 8–14 EM (n = 1500), and chronic migraine (≥ 15; CM; n = 900).

More than 95% of users reported that migraine negatively affected their daily

activities during at least one migraine attack.

44.8% CM, 40.9% 8–14 EM, and 34.7% of 4–7 EM sufferers, respectively,

reported anxiety and/or depression symptoms during migraine attacks.

Employed respondents (n = 3106) reported an average of 2.3 workdays missed per month and that at least one in four migraines led to work absenteeism; these migraines were commonly reported to have at least moderate to severe levels of pain, corresponding to the inability of persons to perform some or even any activities. This study, leveraging patient-reported data collected through a mobile applica- tion, demonstrates the high burden and impact of migraine on health-related quality of life, work productivity, and overall well-being of individuals suffering from migraines.

Introduction Migraines are most often treated with acute therapies, which are used to relieve the pain and associated symptoms of a migraine attack at the time it occurs.

It is recommended for patients in whom acute therapy is either ineffective or contraindicated, in patients with high frequency and severity of migraine, or in patients who suffer significant disability due to aura and other associated symptoms [182, 183]; however, prophylactic treatment is generally underutilized [172, 184].

The objective of the present study was to describe the burden of migraine in terms of impact, symptoms, triggers, and other migraine characteristics as perceived by migraine sufferers in a real-world setting using a self-reported smartphone appli- cation (app), Migraine Buddy©.

This study aimed to assess the burden of migraines in terms of affected daily activities, medication usage, and impact of anxiety and depression in patients who suffer from at least four monthly migraine days (MMDs); evaluate the impact of migraine on work productivity; and describe the characteristics of migraine attacks (pain level, duration, symptoms, triggers) experienced by this population of interest.

Methodology Migraine Buddy is a free smartphone app used to collect self-reported migraine data. The study used anonymized self-reported data from 3900 randomly selected adult Migraine Buddy users, recorded during the 13-month period from June 1, 2015 through July 3, 2016.

Data from individuals who were at least 18 years of age, had agreed to participate in the study, and had more than 70% completeness rates in their migraine records were included in the study sample.

The variables examined in the study included the following: demographic char- acteristics (age, gender); migraine characteristics (triggers, auras, symptoms, pain location and intensity, start time and duration of migraine); migraine burden

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Personal and Societal Burden

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(location of onset, impact on activities such as social, home, work, medication use, or other relief methods); impact of migraine on work productivity [employment status, workdays missed (absenteeism)]; anxiety and depression; and the number of medications used to treat migraine.

Results The most commonly self-reported migraine symptoms were related to pain/body (91.7% of users), mood and cognition (87.3%, which included nausea, anxiety, con- fusion, blurred vision, moodiness, or giddiness), and environment [such as ringing in ears (tinnitus), sensitivity to light, noise, or smell; 85.5%] (each user could spec- ify more than one symptom per record and therefore numbers do not add up to 100%).

Among employed users, migraines were commonly reported to have at least moderate to severe levels of pain (63% of migraine records), and 83% of respon- dents self-reported moderate pain in at least one of their absenteeism-related migraines.

The most commonly reported symptoms recorded by migraine sufferers in work absenteeism-related migraines were body pain (73%), mood and cognition (69%), environmental handicap (65%), depression (24%), and/or sleep alterations (13%).

Discussion Migraine can have a considerable impact on the lives of affected individuals as seen in this sizeable international study, based on self-reported data from individuals suf- fering from at least four MMDs using a digital phone app.

This is an innovative study utilizing the self-report data from the biggest digital app specific for migraine that allows users to voluntarily record and monitor their migraines as they are occurring and understand their own symptoms, triggers, and migraine characteristics; this has the potential for patients and their caregivers or physicians to better manage their disease but also for the wider scientific commu- nity to understand the migraine burden, especially in people of their prime working and reproductive years.

As these data are obtained through a mobile phone app, there is potential bias as the study includes data as reported by users, and no physician diagnosis is used to confirm whether the responder indeed suffers from migraine and the frequency of attacks.

Conclusions The large dataset analyzed retrospectively from 3900 users of a popular migraine application has provided results that are comparable and consistent with previous studies published on the burden of migraine in Europe and the rest of the world [131, 185].

Acknowledgement A machine generated summary based on the work of Vo, Pamela; Paris, Nicolas; Bilitou, Aikaterini; Valena, Tomas; Fang, Juanzhi; Naujoks, Christel; Cameron, Ann; de Reydet de Vulpillieres, Frederic; Cadiou, Francois. 2018 in Neurology and Therapy.

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