The burden of migraine in Belgium: results from the My Migraine Voice Survey.
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1
Novartis (Belgium), Belgium
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2
Novartis Pharma (Switzerland), Switzerland
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3
GfK Health, Switzerland, Switzerland
Objectives
The My Migraine Voice survey aimed to investigate the migraine patient’s journey through the Belgian healthcare system as well as the functional, emotional and economic impact of migraine, with a focus on patients who suffered from at least 4 monthly migraine days and reported use of prophylactic medication.
Methods
The My Migraine Voice online worldwide survey was conducted in partnership with the European Migraine and Headache Alliance (EMHA) in 31 countries, including Belgium, from September 2017 until February 2018. In Belgium, survey respondents were recruited via online panels and patient advocacy organizations. Study participants were adult patients (≥18 years) suffering from migraine. The survey investigated the patient journey, functional and emotional burden of migraine from the patient’s perspective. Additionally, the impact of migraine on work productivity and activities during the past 7 days (prior to survey completion) was evaluated using the Work Productivity and Activity Impairment (WPAI) questionnaire. Descriptive survey results were compared among prophylactic treatment naive, no prior prophylactic treatment failure (TF), 1 TF and ≥2 TF patient subgroups.
Results
A total of 311 Belgian people with migraine completed the survey. More than 80% of the survey participants were women (mean age: 40 years old). A vast majority of recruited patients (252) reported ≥4 migraine days/month over the 3 months preceding the survey and 225 of them (89%) were either currently taking and/or had taken ≥1 prophylactic migraine treatment in the past. Over one third of the respondents (38%) reported having lived with migraine for >20 years. Of 225 patients with a medical diagnosis of migraine, most were diagnosed by a neurologist/headache specialist (68%) and 29% by a general practitioner. Less than half of the participants (48%) were diagnosed within 6 months while for 36% it took >1 year to be diagnosed with migraine. Patients had seen on average 2.5 medical professionals and had about 5 appointments with them before receiving a migraine diagnosis. Around half of the survey respondents (55%) were or had been using prophylactic treatments for >2 years. Top 5 medications were vitamins and supplements (41%), beta-blockers (40%), anti-depressants (32%), anti-epileptics (30%) and ACE-inhibitors (8%). Only 8% of patients were completely satisfied with their prophylactic treatment, followed by 38% who were somewhat satisfied, 15% who were somewhat dissatisfied and 10% who were completely dissatisfied. The main reasons for satisfaction being ease of use, having experienced a significant reduction of symptoms and having experienced a reduction of symptom intensity. The main reasons for dissatisfaction being: having experienced no symptom relief at all, the medication not being a cure and having experienced too many side-effects. Of the 225 migraine patients currently taking and/or having taken a prophylactic treatment in the past, 42 never had a prophylactic treatment failure (TF), 24 had 1 TF and 159 had tried and failed ≥2 prophylactic treatments (≥2 TF). Lack of efficacy, medical expert’s decision and side-effects were reported as the main reasons for switching treatment. For more than half of the survey participants (59%) migraine attacks most often lasted >24 hours, with more women (64%) reporting >24 hour attacks than men (40%). Descriptive analysis of results by prior treatment showed higher percentages of patients having >24 hour attacks as the number of prophylactic treatments tried and failed increased (prophylactic treatment naive: 41%, no TF: 48%, 1 TF: 54%, ≥2 TF: 67%). The survey results also point out that migraine is associated with a significant functional and emotional burden. Many patients (77%) felt very or extremely limited during a migraine attack. The average severity of pain experienced during a migraine attack was rated as severe by 65% of survey respondents (between 8 and 10 on a scale from 0-10). Almost one third of patients (29%) reported being very or extremely fearful of the next migraine attack. The top 3 negative emotions associated with migraine by the survey participants were feelings of people not understanding their pain, feeling guilty for letting people down when not being able to keep commitments and feeling that migraine dictates their life. A majority of respondents (≥50%) reported often or always feeling frustrated, hopeless or helpless, and unable to think clearly due to their migraine, with numbers being highest in the ≥2 TF subgroup. On the other hand, 51% of patients reported having learnt to cope with their condition. Additionally, this study described the impact of migraine on work and activity impairment (WPAI questionnaire) and showed an 8% reduction in working time (absenteeism), a 48% reduction in productivity while working (presenteeism), a 51% reduction in overall work productivity (absenteeism and presenteeism combined) and 53% activity impairment due to migraine. These numbers were aligned with the overall results obtained in the worldwide survey.
Conclusion
The Belgian results of the My Migraine Voice survey demonstrate that migraine is associated with a significant functional, emotional and economic burden. Results by prior prophylactic treatment show a trend towards a higher burden as patients fail an increasing number of prophylactic treatments.
Summary for lay people
The My Migraine Voice online patient survey was a study that aimed to gather information on the patient perspective of migraine from those who suffer from the condition. A total of 311 Belgian people with migraine completed the survey. The results describe the patient’s journey through the healthcare system and employment environment and demonstrate the often considerable social, emotional, functional and economic impact of migraine.
Keywords:
Migraine,
burden of disease,
prophylactic treatment,
Patient Journey,
Belgium
Conference:
Belgian Brain Congress 2018 — Belgian Brain Council, LIEGE, Belgium, 19 Oct - 19 Oct, 2018.
Presentation Type:
e-posters
Topic:
NOVEL STRATEGIES FOR NEUROLOGICAL AND MENTAL DISORDERS: SCIENTIFIC BASIS AND VALUE FOR PATIENT-CENTERED CARE
Citation:
Vanvlasselaer
E,
Vo
P,
Quintana
R,
Carboni
V,
Jansen
M,
Vancayzeele
S and
Tobback
L
(2019). The burden of migraine in Belgium: results from the My Migraine Voice Survey..
Front. Neurosci.
Conference Abstract:
Belgian Brain Congress 2018 — Belgian Brain Council.
doi: 10.3389/conf.fnins.2018.95.00038
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Received:
13 Aug 2018;
Published Online:
17 Jan 2019.
*
Correspondence:
Mrs. Evelyne Vanvlasselaer, Novartis (Belgium), Vilvoorde, Belgium, evelyne.vanvlasselaer@novartis.com