Migraine Disability Is Substantial, Impacts QOL Across Several Countries

Migraine-specific disability, including poor quality of life (QOL) and work and activity impairment, is substantial across multiple countries, according to study findings published in Cephalagia.

Study authors conducted a cross-sectional, web-based survey (Chronic Migraine Epidemiology and Outcomes-International [CaMEO-I] Study) between 2021 and 2022 in Canada, France, Germany, Japan, UK, and US to evaluate headache features and migraine burden.

Respondents aged 18 and older who met modified criteria for migraine consistent with the modified International Classification of Headache Disorders 3rd edition (mICHD-3) and could read and understand the national language of their country of residence were eligible for inclusion. Headache features were measured using the Migraine Symptom Severity Score (MSSS) and the Allodynia Symptom Checklist-12 (ASC-12). The Patient Health Questionnaire-4 (PHQ-4), Migraine-Specific Quality of Life questionnaire version 2.1 (MSQ v2.1), and Work Productivity and Activity Impairment (WPAI) questionnaire were used to evaluate patient-reported outcomes, including symptoms of depression and anxiety, QOL, and productivity. Statistical analysis was performed using SPSS version 29.0.

A total of 14,492 respondents (mean age, 41.7; women, 71.2%; body mass index [BMI] ≥30 kg/m², 22.6%) were included in the study, of whom 812 (33.8%) were from the US, 408 (16.6%) from France, and 130 (5.4%) from Japan. Current use of a preventative treatment for migraine was reported by 11.2% of all respondents.

Overall, the mean MSSS was 15.4. The lowest and highest mean MSSS was reported in Japan (13.7) and the US (16.2), respectively. Of all respondents, 7026 (48.5%) had allodynia with headache per the ASC-12. Rates of allodynia were highest and lowest in the US (58.2%) and France (43.1%), respectively. Mild, moderate, and severe allodynia were reported by 22.2%, 12.9%, and 13.3% respondents, respectively, across all 6 countries.

Among all respondents living with migraine, 5146 (35.5%) reported moderate to severe symptoms of anxiety and/or depression, based on the PHQ-4. The highest and lowest rates were reported in the UK (42.9%) and France (28.9%), respectively.

In all, 5425 (37.4%) respondents reported symptoms of anxiety. The highest and lowest rates were reported in the UK (45.2%) and Japan (31.3%). Similarly, 5278 (36.4%) respondents reported symptoms of depression. The highest and lowest rates were reported in the UK (42.9%) and France (29.7%).

The mean MSQ v2.1 Role Function-Restrictive, Role Function-Preventive, and Emotional Functional domain scores were 60.7, 71.5, and 65.1, respectively.

According to the WPAI, the mean percentage of respondents who reported currently working for pay who missed work in the previous 7 days, who worked impaired in the previous 7 days, and who reported activity impairment was 6.8%, 41.0%, and 45.8%, respectively.

Study limitations include the use of self-reported data, possible selection and recall bias, reduced generalizability of results to low- and middle-income countries, and lack of a control group.

“Further research is warranted to explore potential differences between countries in the prevalence of specific headache features, disability and quality of life, and additional work is needed to raise awareness of the burden and overall impact of migraine worldwide,” the study authors concluded.

Disclosure: This research was supported by AbbVie. Some study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.