Burden of migraine among japanese patients: a cross-sectional National Health and Wellness Survey

DOI: https://doi.org/10.1186/s10194- 020- 01180- 9

Abstract-Summary This study aimed at estimating the disease burden of migraine in Japan and identify- ing factors associated with the burden using the 2017 National Health and Wellness Survey.

Migraine patients were defined by ICHD-3 like criteria with ≥4 monthly head- ache days (MHDs), and non-migraine respondents were selected using 1:4 propen- sity score matching.

Multivariate analyses were conducted to compare Health-related Quality of Life (HRQoL), work productivity and activity impairment (WPAI), healthcare resource utilization (HRU) and costs between the two groups, and to identify factors associ- ated with these outcomes in migraine patients.

In 30,001 respondents, 378 migraine patients were identified.

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Migraine patients had higher absenteeism (6.4% vs. 2.2%), presenteeism (40.2% vs. 22.5%), total work productivity impairment (44.3% vs. 24.5%), total activity impairment (45.0% vs. 23.9%), indirect costs (1,492,520 JPY vs. 808,320 JPY) and more visits to healthcare providers in the past 6 months (7.23 vs. 3.96) (p < 0.001).

Japanese migraine patients experience an incremental burden. Extended: Migraine patients were defined by ICHD-3 like criteria, among

respondents who self-reported experienced migraine in the past 12 months.

Background This includes measuring the burden of disease by use of patient reported outcome tools such as health-related quality of life (HRQoL), the impact of illness on work productivity and the associated economic burden [179].

Japanese studies have shown that 32% of migraine patients reported severe to moderate impairment to social activities including cancellation of work and daily appointments [180].

The primary objective of this study was to estimate the humanistic and economic burden of migraine by comparison of HRQoL, work productivity and activity impairment (WPAI), and healthcare resource utilization (HRU) in individuals with migraine classified according to the International Classification of Headache Disorders third edition (ICHD-3) [20] like criteria and having at least 4 monthly headache days (MHDs).

The secondary objective was to examine the relationship between the humanistic and economic burden of migraine and sociodemographic factors, disease character- istics and comorbidities among Japanese migraine patients.

Methods Migraine patients were defined by ICHD-3 like criteria, among respondents who self-reported experienced migraine in the past 12 months.

Migraine-specific questions were asked to all respondents who experienced migraine, which included: symptoms experienced due to migraine, number of years experiencing migraine, diagnosing physician, number of migraines in the past 30 days and in the past 6 months, number of headache days in the past 30 days, days of missed work due to migraine in the past 6 months, days of missed household activities due to migraine in the past 6 months, use of prescription medication to treat or prevent migraine.

Comparisons between migraine patients and non-migraine respondents were performed using chi-square tests for categorical variables and one-way analysis of variance (ANOVA) for continuous variables, for demographic and general health characteristics, to understand the baseline differences between the two groups.

HRQoL, WPAI, HRU and costs were compared between migraine patients and

matched non-migraine respondents.

Results After adjusting for age, gender, CCI, marital status, education, household income, region, insurance type, employment status, BMI, smoking status, alcohol use and exercise behavior, migraine patients had significantly lower PCS (45.17 vs. 49.89),

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MCS (42.28 vs. 47.71), RCS (37.91 vs. 44.19) and SF-6D index (0.64 vs. 0.74) than matched non-migraine respondents (all p < 0.001).

After adjusting for the same covariates as mentioned above, migraine patients had significantly higher absenteeism (6.4% vs. 2.2%), presenteeism (40.2% vs. 22.5%), total work productivity impairment (44.3% vs. 24.5%) and total activity impairment (45.0% vs. 23.9%) than matched non-migraine respondents (all p < 0.001).

After adjusting for the same covariates, it was estimated that migraine patients incurred significantly more annual indirect cost (1,492,520 JPY vs. 808,320 JPY) compared to matched non-migraine respondents.

Discussion We found that Japanese patients with migraine (with or without aura and with at least 4 MHDs) experienced significantly higher humanistic and economic burden in terms of decreased HRQoL, and increased WPAI, HRU and indirect costs, com- pared to matched non-migraine respondents.

No statistically significant difference in direct costs between migraine patients

and non-migraine respondents was observed in this study.

Indirect costs were significantly lower among non-migraine respondents, indi- cating that the poorer QoL and work productivity among migraine patients have a costly impact on the Japanese society.

A retrospective, observational cohort study in the US identified that migraine patients incurred significantly higher indirect cost due to higher productivity loss, as well as direct cost due to higher level of healthcare utilization, compared to matched patients without migraine [181].

Conclusions Increased number of MHDs among Japanese migraine patients were associated with worse HRQoL and increased HRU.

This demonstrates that better care is needed for Japanese migraine patients.

Acknowledgement A machine generated summary based on the work of Kikui, Shoji; Chen, Yirong; Todaka, Hiroshi; Asao, Keiko; Adachi, Kenji; Takeshima, Takao. 2020  in The Journal of Headache and Pain.

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