PND45 Epidemiology, Treatment Landscape, and Healthcare Utilization for Patients with Migraine in Canada: A Literature Review

Abstract

Statistics Canada estimated 2.7M Canadians were diagnosed with migraine in 2010. Understanding the burden of disease and current treatment patterns is critical for the development of new treatment strategies and improved patient care. The study objective was to describe the treatment landscape and clinical and economic burden of migraine in Canada via a literature review. A search strategy using key terms for migraine was executed in MEDLINE, Embase, and the Cochrane® Library between August 2010 and August 2020 for Canadian populations with migraine. Outcomes included prevalence, clinical or economic measures, and treatments. This review was conducted and reported in accordance with the PRISMA statement. 3269 citations were screened, and 29 Canadian studies were included; 14 studies utilized data from the Canadian Community Health Survey. Statistics Canada (2014) estimated an overall migraine prevalence in Canada of 8.3%. Patients with chronic migraine had a greater burden of disease in terms of cost, resource use, and quality of life compared to episodic migraine. Most patients (74%) with chronic migraine had ≥ 2 comorbidities. Nine studies examined migraine treatment, with 70% of chronic and 80% of episodic migraines treated with acute medications, including 23% with codeine-containing analgesics and 11% with opioids. Most patients (82%) reported previously taking ≥ 3 types of migraine medications. Finally, unemployment ranged from 4% to 33%. Emergency and specialist visits increased by 14% and 5%, respectively, compared to controls, with an average of 24 general physician visits per patient per year, compared to 19 visits on average for controls. The burden of disease for patients with migraine in Canada is substantial. The medication utilization patterns and unemployment in this population highlight an important gap in existing treatment strategies. Likewise, the higher healthcare costs and reduced quality-of-life demonstrate an unmet need for more effective management.