Patients' perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom
Patients' perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom
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DOI：
10.1186/s10194-018-0907-6
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发表时间：
2018-09-10
影响因子：
7.4
通讯作者：
Gupta, Shaloo
中科院分区：
文献类型：
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作者：
Vo, Pamela;Fang, Juanzhi;Gupta, Shaloo
背景：偏头痛是一种独特的神经系统疾病，给患者、社会和医疗保健系统带来巨大负担。本研究旨在通过检查欧盟五国（法国、德国、意大利、西班牙、英国）的健康相关生活质量 (HRQoL)、工作生产力和日常活动损害以及医疗资源利用 (HRU)，来描述每月头痛天数 (MHD) ≥ 4 的个人的偏头痛增量负担。方法：这项回顾性横断面研究使用了 2016 年国家健康与健康调查 (NHWS；N = 80,600）。简式 36 项健康调查，第 2 版 (SF-36v2) 身体和精神成分汇总评分（PCS 和 MCS）、简式 6D (SF-6D) 和 EuroQoL (EQ-5D)、工作生产力和日常活动损伤（工作生产力和活动损伤问卷 (WPAI) 和 HRU）在患有 >= 4 MHD (n = 218) 和患有偏头痛的受访者之间进行比较使用卡方、T 检验和 Mann-Whitney 检验进行倾向评分匹配，以确定倾向评分匹配后各组之间的显着差异。结果：与非偏头痛对照相比，患有 >= 4 MHD 的偏头痛个体的 HRQoL 较低，SF-36v2 PCS 降低（46.00 vs 50.51），并且MCS（37.69 vs 44.82）、SF-6D 健康状态效用评分（0.62 vs 0.71）和 EQ-5D 评分（0.68 vs 0.81）（总体而言，p < 0.001）。患有 >= 4 MHD 的偏头痛受访者也报告了较高的缺勤率（14.43% vs 9.46%；p = 0.001）、出勤率（35.52% vs 20.97%）、整体工作障碍（38. 70% vs 23.27%）和活动障碍（44.17% vs 27.75%）均高于非偏头痛对照组（全部，p < 0.001）。此外，与匹配的对照组相比，MHD 患者的 HRU 显着较高。与非偏头痛对照组相比，（4-7 MHD、8-14 MHD 和 CM）HRQoL 较低，总体工作和活动损害更大，HRU 更高。结论：与非偏头痛对照组相比，≥ 4MHD 的偏头痛与较差的 HRQoL、更大的工作生产力损失和更高的 HRU 相关。研究结果表明，EU5 中患有 ≥ 4MHD 的个体存在未满足的需求。需要有效的预防性治疗来减轻偏头痛的人文和经济负担。
Background: Migraine is a distinct neurological disease that imposes a significant burden on patients, society, and the healthcare system. This study aimed to characterize the incremental burden of migraine in individuals who suffer from monthly >= 4 headache days (MHDs) by examining health-related quality of life (HRQoL), impairments to work productivity and daily activities, and healthcare resource utilization (HRU) in the EU5 (France, Germany, Italy, Spain, United Kingdom).Methods: This retrospective cross-sectional study used data from the 2016 National Health and Wellness Survey (NHWS; N = 80,600). Short-Form 36-Item Health Survey, version 2 (SF-36v2) physical and mental component summary scores (PCS and MCS), Short-form-6D (SF-6D), and EuroQoL (EQ-5D), impairments to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire (WPAI), and HRU were compared between migraine respondents suffering from >= 4 MHDs (n = 218) and non-migraine controls (n = 218) by propensity score matching using sociodemographic characteristics. Chi-square, T-tests, and Mann-Whitney tests were performed to determine significant differences between the groups after propensity score matching.Results: HRQoL was lower in migraine individuals suffering from >= 4 MHDs compared with non-migraine controls, with reduced SF-36v2 PCS (46.00 vs 50.51) and MCS (37.69 vs 44.82), SF-6D health state utility score (0.62 vs 0.71), and EQ-5D score (0.68 vs 0.81) (for all, p < 0.001). Respondents with migraine suffering from >= 4 MHDs also reported higher levels of absenteeism from work (14.43% vs 9.46%; p = 0.001), presenteeism (35.52% vs 20.97%), overall work impairment (38. 70% vs 23.27%), and activity impairment (44.17% vs 27.75%) than non-migraine controls (for all, p < 0.001). Additionally, HRU was significantly higher for individuals with MHDs compared to their matched controls. Consistently, migraine subgroups (4-7 MHDs, 8-14 MHDs and CM) had lower HRQoL, greater overall work and activity impairment, and higher HRU compared to non-migraine controls.Conclusions: Migraine of >= 4MHDs was associated with poorer HRQoL, greater work productivity loss, and higher HRU compared with non-migraine controls. The findings of the study suggest that an unmet need exists among individuals suffering from >= 4MHDs in the EU5 suggesting the need for effective prophylactic treatments to lessen the humanistic and economic burden of migraine.