Abstract

BackgroundEvaluation of the prevalence and impact of headache on the preceding day (“headache yesterday”; HY) is a new approach, allowing more precise estimation of headache-attributed burden without recall error. The aim of the study was to estimate the national burden attributable to headache disorders in Russia by applying measures of prevalence of HY and its impact on productivity and daily activities in the general population.MethodsWe interviewed a representative population-based sample face-to-face by visiting randomly selected households throughout Russia. We randomly selected one adult aged 18–65 years from each. We followed a structured questionnaire including diagnostic questions, enquiry into occurrence of HY and various aspects of attributed burden.ResultsParticipation rate was 74.3%. One in seven participants (14.5%; men 9.1%: women 19.3%) reported HY. Approximately half of these had one of the subtypes of headache occurring on ≥15 days/month; the remainder had episodic migraine or tension-type headache almost equally. Mean duration of headache was 6.0 ± 4.4 hours. In 88.3% headache intensity was moderate or severe (mean 2.1 on a scale 1–3) and in 73.9% HY impaired daily activity. Loss of productivity at work due to headache totalled 2.6 million person-years/year, or 4.0% of workforce capacity. This estimate exceeded by 70% a previous estimate from the same survey based on recall over the preceding 3 months. There was greater impact on other daily activities.ConclusionRecall-error-free estimation shows lost productivity every day due to headache in the Russian population is enormously high. Measures to redress these losses – effective structured health-care services supported by educational programmes – should be seen as a public-health priority while almost certainly being cost-saving.

Highlights

  • Evaluation of the prevalence and impact of headache on the preceding day (“headache yesterday”; Headache yesterday (HY)) is a new approach, allowing more precise estimation of headache-attributed burden without recall error

  • Some have estimated headache-attributed burden, and those assessing socioeconomic impact have employed questionnaires such as the Migraine Disability Assessment (MIDAS) instrument [5] or its derivative, the Headache-Attributed Lost Time (HALT) questionnaire [5,6]. The former, and in its original form (HALT-90) the latter, depend upon enquiry relating to the three months prior to the interview, an approach subject to the limitations and errors of recall over such a long period [7]. The consequences of these limitations, errors and possible biases need to be considered, and an alternative approach that allows this is enquiry into headache occurring on the day before the interview (“headache yesterday”; HY)

  • The participating sample were aged 39.5 (SD ± 13.4) years, compared with the national population mean of 39.2 years, and 47.4% were male

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Summary

Introduction

Evaluation of the prevalence and impact of headache on the preceding day (“headache yesterday”; HY) is a new approach, allowing more precise estimation of headache-attributed burden without recall error. The Global Burden of Disease Survey 2010 (GBD2010) ranked tension-type headache (TTH) and migraine as the second and third most common diseases worldwide [1] These primary headache disorders are associated with disability, reduced quality of life, public ill health and high economic burdens on both individual and population levels. Some have estimated headache-attributed burden, and those assessing socioeconomic impact have employed questionnaires such as the Migraine Disability Assessment (MIDAS) instrument [5] or its derivative, the Headache-Attributed Lost Time (HALT) questionnaire [5,6] The former, and in its original form (HALT-90) the latter, depend upon enquiry relating to the three months prior to the interview, an approach subject to the limitations and errors (and possible biases) of recall over such a long period [7]. Diagnosis cannot reliably be based on a single headache episode; unless a respondent can report that HY is typical of a recurrent headache that has been diagnosed, its nature will not be known

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