Effect of Migraine Headache on Productivity of Patients According to Migraine Disability Assessment Score: A Cross-Sectional Study

DOI: https://doi.org/10.1007/s40122- 019- 0130- 4

Abstract-Summary Migraine is the third most common cause of disability under the age of 50.

There are various scoring systems for assessing this disability, one of which is

MIDAS; the Migraine Disability Assessment Score.

The objective of our study was to determine the extent of disability among

migraine patients, patterns of prophylaxis, and their healthcare-seeking behaviors.

This survey was done in 50 migraine patients at Jinnah postgraduate medical

Centre from April to May 2018.

The questionnaire inquired about the demographic information, management of migraine, and effect of this condition on their sleep, and the last part had assessment to know about their functional disability.

Acetaminophen was the most common medication used during a migraine attack,

followed by nonsteroidal anti-inflammatory drugs.

The majority of migraine patients were found to have severe disability, which

affected their daily work and social activities.

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1 Public Health

Despite an increase in disability rate due to migraine, people do not seek regular

medical care for this type of headache in Pakistan.

Extended: The majority of patients felt that they have developed tolerance. Despite an increase in disability rate due to migraine, the trend of people towards

seeking regular medical care and prophylaxis is low in Pakistan.

Introduction These factors further promote disability in migraine patients.

The onset of headache was earlier in patients with migraine, who reported a first-

degree family history of the disease [311].

Research conducted on medical students of Karachi, Pakistan, revealed that

migraine was the most common type of headache among the target population.

Different scoring systems have been suggested, one of which is MIDAS; the

Migraine Disability Assessment Score.

The aim of our study was to evaluate migraine-associated disability among the

population in Pakistan using the MIDAS questionnaire.

There are limited data available regarding migraine-associated costs and disabil- ity in Pakistan and the findings of our work will contribute towards the existing studies.

The purpose of our research is to determine the extent of disability among migraine patients in the region, patterns of prophylaxis, and healthcare-seeking behaviors among the effected group.

Methods Participants were included after consenting to the study, which was approved by the ethical committee of JPMC.

The questionnaire was comprised of three parts, the first part inquired about demographic information, while the second part consisted of questions regarding the use of medications during the migraine attack, prophylaxis taken, and pattern of visiting health care facility during or after the migraine symptoms.

The subjects were asked about their sleeping habits and the possible effect of migraine on their sleeping patterns was assessed based on the participant’s self-interpretation.

The third part of questionnaire had assessment for calculating the MIDAS score, that is, an inability/reduced ability of more than 50% to attend work or school, the inability/reduced ability to do household work, the inability to participate in non- work- related activities (total scores: 0–3 in each headache attack) [141].

Results Acetaminophen was the most common medication used by the individuals during a migraine attack (48%), followed by nonsteroidal anti-inflammatory drugs (40%).

Many individuals did not take any prophylaxis (46%) and the majority (54%) of

subjects admitted using prophylaxis.

β-blockers were the most common prophylaxis used (20%), followed by tricyclic

antidepressants (18%).

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Personal and Societal Burden

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There was a lower tendency of going to follow-ups with health care among indi-

viduals with migraine and only 32% had a follow-up visit with doctors.

Discussion Individuals suffering from migraine-related disability experience difficulties in maintaining a work and household routine and struggle with socializing activities, which is consistent with the results of our study [312].

Studies have shown that gender has a direct effect on the intensity of migraine

attacks.

A study reported a higher prevalence of severe migraine in females as compared

to males and females suffered greater migraine-related disabilities [313].

A study conducted in Psychiatry Tertiary Care Hospital in New Delhi revealed that 66.0% of females with migraines scored low on the Female Sexual Function Index, an indication of lower sexuality as compared to the control group (33%) [314]. Our study showed β-blockers as the most common prophylactic used for migraine, however this is different from the finding in another study where the use of anti-depressants was more common [315].

Conclusions Most of the results in our study are consistent with migraine-related studies con- ducted in other countries.

Acknowledgement A machine generated summary based on the work of Jawed, Shafaq; Ali, Waqar; Yaqoob, Uzair; Shah, Shahnaz; Uddin, Syed Mohammad Mazhar; Haq, Aatera. 2019 in Pain and Therapy.

A cross-sectional study on the burden and impact of migraine on work productivity and quality of life in selected workplaces in the Philippines