Impact of COVID-19 pandemic on migraine management in the United States: insights from migraine tracking app users

DOI: https://doi.org/10.1186/s12883- 021- 02378- 3

Abstract-Summary The nature of COVID-19 pandemic measures has altered the clinical management of migraine, and has also created barriers to evaluate the impact of such measures of migraine patients.

Using the Migraine Buddy smartphone application, we assessed the impact of

the COVID-19 pandemic on migraine in users residing in the United States.

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Anonymized self-reported data from 163,176 adult Migraine Buddy users in the United States between January 2020 and May 2020, were analyzed for migraines associated with stress.

A questionnaire on the impact of COVID-19 on migraine and its management was also completed by 923 users from the United States in the app between April 2020 and May 2020.

The proportion of stress-related migraine attacks peaked at 53% on March

21–23, although the number of migraine attacks decreased.

To help manage migraine during COVID-19, respondents suggested stress and diet coaching programs and resources (medical articles, etc.) (34.0%), having the option for home delivery of medication (30.6%) and tele-consulting (25.5%).

We report the change in the proportion of self-reported stress-related migraine in relation to evolution of the COVID-19 pandemic, as well as its impact of migraine management.

Extended: Using the Migraine Buddy app, this study aimed to assess impact of the COVID-19 pandemic on migraine in Migraine Buddy users who reside in the United States.

Only self-reported migraine records are included in the analysis. Anonymized self-reported data from 163,176 adult Migraine Buddy users in the United States over the 5-month period from January 1, 2020 through May 31, 2020 were extracted from the Migraine Buddy database.

The analysis of information about the body, collected via wearables, together with self-reported data entered into the migraine diary, can be performed by artifi- cial intelligence to provide migraine patients with feedback to optimize their migraine management.

Background As of May 30, 2020, New York has been the virus’ epicenter in the United States with 23,780 deaths and 368,234 cases [301].

It is difficult to assess the impact of COVID-19 for migraine patients without

face-to-face consultations.

Through the app, Migraine Buddy users also provide real-time insights via sur- veys and their diary records, which allows the Healint data analytics platform to extract key anonymized aggregated findings.

Using the Migraine Buddy app, this study aimed to assess impact of the COVID-19 pandemic on migraine in Migraine Buddy users who reside in the United States.

Methods The study is a non-interventional, retrospective analysis of data that is self-reported via the Migraine Buddy smartphone application.

Only self-reported migraine records are included in the analysis. Anonymized self-reported data from 163,176 adult Migraine Buddy users in the United States over the 5-month period from January 1, 2020 through May 31, 2020 were extracted from the Migraine Buddy database.

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A stress-related migraine is defined as one in which stress or anxiety were self-

reported as a trigger or symptom in the Migraine Buddy records.

The stress-related migraine group includes individuals who reported at least 1

stress-related migraine in each calendar month of the study period.

To the Migraine Buddy records, a questionnaire survey was sent to Migraine Buddy users in the United States, and completed in the app between April 2020 and May 2020.

Results The stress-related migraine group had a higher proportion of women than the migraine group that did not reported stress-related migraine (p < 0.0001).

The number of recorded migraine attacks and proportion of stress-related migraine follow a consistent pattern when there is a sharp decrease on Saturday and Sunday, followed by an increase on Monday.

The proportion of stress-related migraine attacks recorded in Migraine Buddy reached the peak value of 53% on March 21–23, although the number of recorded migraine attacks decreased.

The proportion of stress-related migraine gradually decreased.

Discussion We reported an increase in the proportion of stress-related migraine at the beginning of the COVID-19 pandemic.

Similar to our findings, an online survey conducted in Kuwait demonstrated that the majority of respondents had reported increase in migraine frequency and sever- ity during pandemic period [218].

From our questionnaire, 13.5% of respondents reported a reduction in migraine frequency and 11.2% reported improvement of migraine severity during pan- demic period.

A recent study of Italian working women revealed that most of the additional housework and childcare duties associated with the COVID-19 pandemic were managed on predominantly by females, which coincidentally may be an added source of migraine trigger [302].

Being an observational study conducted via a smartphone app, the establishment of a direct causal relationship between migraine and COVID-19 pandemic can be difficult.

Conclusion From these responses, we propose that headache specialists continue to develop appropriate strategies to help patients manage migraine and mental health.

Our data will help increase the understanding of patients’ needs and help in the

planning and execution of such mitigating strategies.

Acknowledgement A machine generated summary based on the work of Kato, Yuji; Poh, Weijie; Horvath, Zsolt; Cadiou, François; Shimazu, Tomokazu; Maruki, Yuichi 2021  in BMC Neurology.

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