Assessing the impact of migraine on health-related quality of life: An additional use of the quality of well-being scale-self-administered.
OBJECTIVE
To compare the interviewer-administered Quality of Well-being Scale (QWB) with a self-administered form (QWB-SA) for patients with migraine, and to compare the health status of migraineurs to other medical populations.


BACKGROUND
With the increasing need to document the cost-effectiveness of treatment for migraine, limitations with both the Medical Outcomes Study Short Form-36 items and the QWB have been an impediment to research using cost-effectiveness as an outcome. Demonstrating the sensitivity of an alternative instrument which addresses these limitations would facilitate cost-effectiveness analyses on treatments for migraine.


METHODS
Eighty-nine adults (87% women) known to suffer from migraine were asked to complete both the interviewer-administered QWB and the self-administered version (QWB-SA) on three occasions. The first occasion was on a day when no migraine was experienced in the previous 7 days. The second and third assessments were completed within 48 hours of the onset of a migraine.


RESULTS
While both the QWB and the QWB-SA successfully distinguished migraine from nonmigraine days, more migraines were reported on the QWB-SA. Overall, both instruments showed similar patterns of patient dysfunction during a migraine attack. Each component of the QWB-SA successfully distinguished migraine from nonmigraine days, and the QWB-SA showed a linear sensitivity to pain intensity and disability during a migraine episode. Both instruments are able to detect a migraine's effect on multiple domains of quality of life. Study participants scored significantly lower on the QWB-SA during a migraine episode than several comparison medical populations.


CONCLUSIONS
The QWB and the QWB-SA appear to have sensitivity to migraine severity, and the ability to quantitate an effect in multiple quality-of-life domains. Both measures can be used to calculate quality-adjusted life-years, thus facilitating cost-effectiveness and health policy work in this important clinical area.
Sieber
W J
WJ
University of California, San Diego Health Outcomes Assessment Program, San Diego, CA, USA.
David
K M
KM
Adams
J E
JE
Kaplan
R M
RM
Ganiats
T G
TG
D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology*; D011788:Quality of Life; D012646:Self Administration; D018434:Sickness Impact Profile