Medication adherence in migraine patients (data of an online survey)

Patient needs, drug intake patterns, and adherence to therapy are significant challenges in the management of migraine patients.Objective: to identify drug treatment needs, drug use patterns and adherence factors in migraine patients.Patients and methods. An online survey was conducted among Internet users through social networks (Instagram, Facebook, Vkontakte) from 01/22/2020 to 02/22/2020. The selection of respondents was based on an anamnesis of headaches and passing the ID Migraine screener. One thousand five hundred ninety-eight individuals (93.8% women and 6.2% men) aged 18—39years participated in the survey.Results and discussion. Among 1598 participants, 1490 experienced any headache, 937 respondents noted migraine symptoms, and 542 (58.4%) had a migraine diagnosis. 899 (96%) of responders used medications to relieve headaches, and in 59% of them drugs were self-prescribed. 125 (13%) patients received prophylactic therapy for migraine, of which only 47 (37.6%) complied with the prescribed treatment. We found a significant (p=0.019) association between the degree of adherence to therapy and the number of days with migraine.Conclusion. The study revealed a low referral rate in patients with headaches. In addition, more than half self-prescribed the drug for headache relief, and only a third of patients complied with the prescribed prophylactic treatment.

Prevalence of Migraine Headaches and their Impact on the Academic performance of Medical Campus Students at University of Khartoum using ID-Migraine test as a screening tool: A cross-sectional study from Sudan

Background Migraine — an episodic headache —is one of the most common types of primary Headache. Migraine is considered a serious health problem that affects the quality of life. During university life, students often report increased levels of stress, depression, anxiety, and irregular sleep, all of which are associated with migraines.Our aim was to determine the prevalence of migraine headaches among medical campus students at university of Khartoum, Sudan. Based on available data, migraine is on the rise in both general populations as well as university students.Methods In this cross-sectional and descriptive study, study population was composed of students registered to faculty of medicine, Dentistry and pharmacy at Khartoum University in the academic years of 2020–2021. Out of these 318 of them accepted to participate. Participants who had two or more headaches in the last 3 months formed the headache group. Afterwards, two preliminary questions were applied to the headache group and participants with at least one affirmative response were asked to perform the validated ID-Migraine™ test.Results The mean age of 318 students participated in the study was 19.23 ± 1.84 (17–39 years), with adolescents: adult ratio being 2.5:1. 1613 students (43.7%) did have at least two headaches in the last three months. Migraine-type headache was detected in 266 subjects (7.2%) based on the ID-Migraine™ test. Of the migraine group, 72 were male (27.1%) and 194 were female (72.9%). There was no significant difference in migraine prevalence between adolescent and adult age groups.Conclusions With prevalence similar to adults, primary care physicians should be aware of the probability of migraine headaches in university students in order to maintain a successful school performance.

Migrânea e anticoncepcionais: riscos e autoconhecimento

IntroduçãoOs anticoncepcionais hormonais (ACH) são o método de maior prevalência entre as medidas medicamentosas, pois constituem o mais eficaz e reversível recurso de contracepção. Ademais, tais medicamentos também estão associados a uma maior prevalência de migrânea em suas usuárias, combinação essa comprovadamente apontada como fator de risco para desenvolvimento de doenças cerebrovasculares (DCV).Material e MétodosA presente pesquisa compreendeu um estudo transversal observacional. A amostra foi composta por 1000 mulheres, de 18 a 44 anos de idade que são usuárias do sistema público de saúde na cidade de Barbacena - MG. Foi aplicado a elas o ID-Migraine, formulário que contempla realizar o diagnóstico de migrânea, além de perguntas relacionadas ao objetivo do trabalho.ResultadosObservou-se que das 1000 entrevistadas, 613 (61,3%) (IC 95% 58,0% - 64,0%) foram diagnosticadas como migranosas. Dessas, 305(49,7%) (IC 95% 45,7% - 53,7%) faziam uso de ACH. Das 305, 264 (86,5%) (IC 95% 88,2% - 90,3%) eram usuárias de ACH por prescrição médica, das quais 150 (57%) (IC 95% 50,8% - 62,8%) tinham conhecimento prévio do risco de desenvolver DCV com uso de ACH, e apenas 87 (32,9%) (IC 95% 27,2% - 38,6%) conheciam sobre a relação do uso de ACH associado à migrânea e o risco de desenvolvimento/agravo de DCV.ConclusãoObservou-se que mesmo sob prescrição médica, grande parte da população estudada migranosa e usuária de ACH não tinha conhecimento sobre os riscos de seu uso, e que uma parcela ainda maior desconhecia os riscos de desenvolvimento/agravo de DCV com o uso de ACH e presença concomitante de migrânea. Evidenciando-se assim a necessidade de melhoria na atenção primária da mulher.

Assessment of Work Productivity and Activity Impairment (WPAI) questionnaire for migraine with the help of a smartphone app

ABSTRACT Background: Migraine is a major cause of disability, which affects many areas of life, including productivity at work. Measuring absenteeism and presenteeism resulting from migraine with the use of appropriate tools is essential for better understanding the impact of this disease. Objective: The aim of the present study was to assess the work impact of migraine using the Brazilian Portuguese version of Work Productivity and Activity Impairment (WPAI) questionnaire. Methods: This survey was carried out with the aid of a smartphone app (Dr Cefaleia for Doctors) containing the questionnaires: ID-Migraine, Headache Impact Test (HIT-6), and WPAI. The data were collected during a headache awareness event. Correlations were assessed between migraine impact (HIT-6) with WPAI parameters: a) work time missed (absenteeism), b) impairment at work (presenteeism), c) overall work productivity loss (absenteeism+presenteeism), and d) activity impairment outside work. Results: Overall, 305 subjects with headache were interviewed and 167 were classified as having migraine. No significant differences in migraine impact according to sex (p=0.8) and modality of work were registered (p=0.8). Females had significantly higher absenteeism score (p<0.001), but presenteeism score was not significantly different between genders (p=0.3). WPAI absenteeism and presenteeism scores significantly correlated with migraine impact (HIT-6). Conclusions: The results suggest WPAI Brazilian Portuguese version was efficient in assessing migraine related work impact. The use of an app with validated questionnaires facilitates the conduction of migraine impact research in different populations, allowing a better understanding of the burden of this disease.

Translation and validation of an extended German version of ID Migraine™ as a migraine screening tool

Background and purpose: Diagnosing a patient with headache as a migraineur is critical for state-of-the-art migraine management. Screening tools are imperative means to improve the diagnostic yield in the primary care settings and specialized clinics. This study aims to translate and assess the diagnostic accuracy of a German version of the ID Migraine™ as a widely used and efficient screening instrument. Methods: The Functional Assessment of Chronic Illness Therapy translation methodology was used to translate the original three-item ID Migraine™, including a fourth question for aura, from the English language into the German language. Diagnostic accuracy of the German ID Migraine™ and predictors of false screening results were assessed among patients presenting to a headache outpatient clinic of a tertiary care center in Germany over a 6-month period. Results: The translation procedure yielded a harmonized German ID Migraine™ and its diagnostic accuracy was assessed in 105 patients (80 female, 46.5 ± 17.2 years of age), including 79 patients (75.2%) with migraine. The three-item German ID Migraine™ provides a sensitivity of 99%, specificity of 68%, and positive and negative predictive values of 90% and 95%, respectively, using a cutoff of ≥2. Positive and negative predictive values in a general headache population are estimated to be 74% and 98%, respectively. The aura question identified 18 out of 20 migraineurs with aura. Conclusions: The German ID Migraine™ is an accurate screening tool for migraine even in a challenging population of a specialized outpatient clinic. Its diagnostic accuracy indicates a potential utility for screening in primary health care.

Migraine in 746 patients with multiple sclerosis

ABSTRACT Migraine adds to the burden of patients suffering from multiple sclerosis (MS). The ID-migraine is a useful tool for screening migraine, and the Migraine Disability Assessment questionnaire can evaluate disease burden. The aim of the present study was to assess the presence and burden of migraine in patients with MS. Methods: Patients diagnosed with MS attending specialized MS units were invited to answer an online survey if they also experienced headache. Results: The study included 746 complete responses from patients with MS and headache. There were 625 women and 121 men, and 69% of all the patients were aged between 20 and 40 years. Migraine was identified in 404 patients (54.1%) and a moderate-to-high burden of disease was observed in 68.3% of the patients. Conclusion: Migraine is a frequent and disabling type of primary headache reported by patients with MS.

Prevalence of Migraine and Trigger Factors among Adult Rural Sudanese Population 2018

Background: Migraine is one of the most common types of headache; it is a chronic neurological disease that affects 15% of the population, however, information about its prevalence in Sudan is scarce. Aim: The aim of this study was to study prevalence of migraine and trigger factors among adult rural Sudanese population in 2018. Setting and Design: This is a cross sectional two-stage door-to-door community-based study conducted in 16 administrative areas in rural Sudan. Materials and Methods: A sample of 8610 adult Sudanese individuals, 18 years and above was selected. A structured pretested questionnaire was used included questions about two or more headaches in the last three months for screening. Participants with at least one positive response were asked to perform the 3-item validated Identification of Migraine (ID Migraine) test. Data was analyzed by SPSS version 20 for descriptive statistics and one way chi square test was used for testing the association of triggering factors with migraine at 95% confidence level of significant. Results: Four hundred and sixty eight had migraine with a prevalence rate of 5.4% among 8610 study population. The prevalence of migraine was 40% among those having at least two episodes of headache. Females were significantly affected by migraine more than males, P- value 0.044. Migraine significantly decreases with increase in age showed the highest frequency among the age group 18-29 years (38.0%). Family history of migraine accounted to 83.4% of population with migraine. Population with migraine who experienced aura was 64.5%. Already diagnosed population with migraine was 38.9%.The most important triggering factors among population with migraine were irregular/lack of sleep followed by stress/anxiety, noise and fatigue/physical activity, 91.0%, 88.0%, 85.7% and 84.6% respectively. The females experienced migraine with menstruation accounted to 46.7%. Perceived migraine effect was moderate to severe on work/ daily activities/ leisure of 78.2% of population with migraine. Conclusion: Migraine prevalence was alarming in this study. A gap exists in the diagnosis of migraine that needs efforts to reduce the sufferings of affected population.

ID-Migraine is a sensitive tool for screening migraine among patients with multiple sclerosis

Introduction: Migraine and multiple sclerosis (MS) have been described as comorbidities. While other types of headaches can be seen in patients with MS, it is migraine that usually adds to the burden of patients suffering from an already disabling and chronic neurological disease. Migraine is more prevalent in patients with MS than in the general population, and can be worsened by certain treatments that are used to control MS. ID-migraine is a tool to screen migraine in a population. It consists of only three self-reported questions, and shows good sensitivity, specificity and reliability. The aim of the present study was to assess the role of ID-migraine as a potential tool for screening migraine in patients with MS. Method: Patients diagnosed with MS for at least one year were invited to answer ID-migraine. Demographic data and information on MS therapy were obtained at the same time. Results: Sixty-two patients participated in the study. There were 16 men and 46 women, of average age 35 years. Migraine was identified in 51.5% of them and 18% reported having the characteristics of chronic migraine. ID-migraine showed 93% sensitivity and specificity for migraine in this population. The medication most frequently associated with worsening of previous migraine was interferon beta 1-a (27.4% of the cases). Conclusion: ID-migraine was shown to be a potential tool for identifying migraine in patients with MS. However, the high prevalence of migraine in this population may have constituted a selection bias, since mostpatients without headache may not have felt inclined to participate in this voluntary investigation. The results from this pilot study will be expanded and investigated in more detail in a large national study.