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Prevalence and impact of migraine and probable migraine in a health plan

From AdvancePCS (Drs. Patel, Kolodner, and Leotta), Hunt-Valley, MD, Departments of Neurology (Drs. Bigal and Lipton) and Epidemiology and Social Medicine (Dr. Lipton), Albert Einstein College of Medicine, Bronx, New York, New England Center for Headache (Dr. Kolodner), Stamford, CT, and Center for Health Services Research (Dr. Lafata), Henry Ford Health System, Detroit, MI.

Address correspondence and reprint requests to Dr. Richard B. Lipton, Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461; e-mail: Rlipton{at}aecom.yu.edu

Background: A large number of headache sufferers with features of migraine fail to meet criteria for strict migraine (SM; migraine with or without aura) but do meet criteria for probable migraine (PM).

Objectives: To estimate the prevalence of PM, to compare the epidemiologic profiles of SM and PM, and to assess the disability and impact on the health-related quality of life (HRQoL) of these patients.

Methods: Computer-assisted telephone interviews in a sample recruited from a mixed model health maintenance organization were used. SM, PM, and control subjects were identified. Also assessed were demographic features, disability, HRQoL, and depression.

Results: The 1-year prevalence for SM was 14.7% (19.2% in women and 6.6% in men); for PM, it was 14.6% (15.9% in women, 12.6% in men). Most subjects with PM (82%) did not meet the associated symptom criteria for migraine. HRQoL was reduced in the PM, SM, and all migraine (AM; SM and PM pooled together) groups compared with controls. The proportion of subjects with high disability was elevated in PM (13%), SM (31%), and AM (22%) groups vs controls (3.7%; p < 0.0001).

Conclusions: Within a health plan, probable migraine is a prevalent form of migraine, with symptom and epidemiologic profiles that overlap with strict migraine. Although strict migraine prevalence was consistent with previous studies, a probable migraine prevalence higher than previously reported was found, perhaps reflecting a difference between health plan and population samples.

Received February 20, 2004. Accepted in final form June 17, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 26 issue to find the title link for this article.

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October 26 Highlights
Neurology 2004 63: 1346-1347. [Full Text] [PDF]

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