Abstract
BackgroundThe highest prevalence of migraine is detected among people who are of working age. The aim of this study was to assess the burden of migraine in an occupational health care setting using real world data collected as a part of routine clinical practice.MethodsThis retrospective register study included migraineurs using occupational health care at the private health care provider Terveystalo. An age and gender matched control population was established for comparison. Electronic medical records were assessed for overall and migraine related health care visits, sick-leaves and comorbidities. Stratification to acute and prophylactic treatment groups along with prophylactic treatment lines was based on prescriptions.ResultsAmong the 369,383 individuals in the study cohort, 7.4% women and 2.1% men were identified having a diagnosis of migraine. Prophylactic medication was prescribed to 13% of migraine patients and exclusively acute medication to 37%. Although migraine related visits and sick-leave days were significantly lower than overall visits or sick-leave days, both increased by prophylactic treatment line. The number of visits rose from 13.8 to 26.2 and sick-leave days from 16.8 to 30.4 per patient-year, in those without prophylaxis vs. ≥3 prophylactic treatments. Moreover, migraine patients had 1.7-fold increase in visits and 1.8-fold increase in sick leave days on average per patient-year, when compared to the control population. Depression and anxiety were 1.8-fold more common among patients with migraine, and the frequency also increase by treatment line.ConclusionsMigraine burden increased by each failed treatment line and was associated with increased comorbidity. In addition, migraine patients had significantly higher extent of visits and sick-leave days as well as extent of comorbidities when compared to their age- and gender-matched counterparts.
Highlights
Migraine has a significant and debilitating impact on physical, social, and occupational functioning
The main aim of the present study was to examine the burden of migraine and evaluate health care resource use (HCRU), sick-leaves and comorbidities among migraine patients compared to a control population in occupational health care setting
A similar trend was observed for other comorbidities. In this extensive registry-based retrospective study using Electronic medical records (EMR) of Finland’s largest private occupational health care provider, 17,623 migraine patients with G43-diagnosis were identified. In this data migraine was associated with substantial morbidity evident as increased comorbidities, as well as increased health care visits and sick leave days when compared to controls
Summary
Migraine has a significant and debilitating impact on physical, social, and occupational functioning. Migraine is classified into episodic (EM) or chronic (CM) according to monthly migraine days. This classification is not unambiguous, and fluctuations between the Korolainen et al The Journal of Headache and Pain (2019) 20:13 known that e.g. depression and anxiety, as comorbidities among migraine patients, increase both direct and indirect costs [16, 18, 19]. None of the current prophylactic treatments have originally been developed for migraine, and their specific mechanisms of action in migraine are not known. Up to 88% on prophylactic treatment reported lack of efficacy as the reason for treatment switch [22]. The attention has recently turned into revealing the true impact of migraine disease burden for patients in the need or failing prophylactic treatments [5, 23]. The aim of this study was to assess the burden of migraine in an occupational health care setting using real world data collected as a part of routine clinical practice
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