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From Merck Research Laboratories (M.E.B.), Merck Inc., Whitehouse Station, NJ; Departments of Neurology (M.E.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Vedanta Research (D.S., M.R.), Chapel Hill, NC; and The Montefiore Headache Center (R.B.L.), Bronx, NY.
Address correspondence and reprint requests to Dr. Marcelo E. Bigal, Merck Research Laboratories, 1 Merck Drive, Whitehouse Station, NJ 08889 marcelo_bigal{at}merck.com
Objective: To evaluate the disability profile and patterns of treatment and health care use for chronic migraine (CM) in the general population, in contrast to episodic migraine.
Methods: We identified 24,000 headache sufferers, drawn from more than 165,000 individuals representative of the US population. This sample has been followed up with annual surveys using validated questionnaires for the diagnosis of episodic migraine and CM. As a part of the survey, subjects were asked to report the specific medications currently used for their most severe headaches, as well as level of satisfaction with treatment.
Results: Our sample consisted of 520 individuals with CM and 9,424 with episodic migraine. Over a 3-month period, more than half of the individuals with CM missed at least 5 days of household work, compared with 24.3% of those with episodic migraine (p < 0.001). Reduced productivity in household work for at least 5 days over 3 months was reported by 58.1% and 18.2% (p < 0.001); at least 5 days of missed family activities was reported by 36.9% and 9.5% (p < 0.001). The majority of the CM sufferers (87.6%) had previously sought care to discuss their headaches with a health professional. Migraine-specific acute treatments were used by 31.6% of respondents with CM and 24.8% with episodic migraine. Around 48% of the individuals with CM were satisfied with their acute therapies. Just 33.3% of those with CM were currently using preventive medications.
Conclusion: Chronic migraine (CM) is more disabling than episodic migraine in the population. Although most individuals with CM sought medical care for this disorder, the majority did not receive specific acute or preventive medications.
Abbreviations: AMPP = American Migraine Prevalence and Prevention; CM = chronic migraine; CM-R = chronic migraine, revised definition; ICHD-2 = International Classification of Headache Disorders, Second Edition; MIDAS = Migraine Disability Assessment; NSAID = nonsteroidal anti-inflammatory drug; OR = odds ratio; TM = transformed migraine.
Supplemental data at www.neurology.org
Disclosure: This study was sponsored by the National Headache Foundation through grants from Ortho-McNeil Neurologics, Inc., and Allergan Inc. M.E.B. started employment at Merck on December 31, 2007. M.E.B. and R.B.L. received grant support, were in advisory boards over the past 12 months, or were on the speakers’ bureau of Merck, AstraZeneca, Pfizer, GlaxoSmithKline, Allergan, Endo, and Ortho-McNeil Pharmaceutical, among other companies. D.S. and M.R. received research support from Ortho-McNeil Pharmaceutical and Allergan.
Received January 11, 2008. Accepted in final form May 6, 2008.
This article has been cited by other articles:
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  Chronic Migraine: Impact and Use of Treatment Journal Watch Neurology, October 28, 2008; 2008(1028): 2 - 2. [Full Text]
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