Migraine in the United States: epidemiology and patterns of health care use.
OBJECTIVE
To determine the prevalence and distribution of migraine in the United States as well as current patterns of health care use.


METHODS
A random-digit-dial, computer-assisted telephone interview (CATI) survey was conducted in Philadelphia County, PA, in 1998. The CATI identifies individuals with migraine (categories 1.1 and 1.2) as defined by the diagnostic criteria of the International Headache Society with high sensitivity (85%) and specificity (96%). Interviews were completed in 4,376 subjects to identify 568 with migraine. Those with 6 or more attacks per year (n = 410) were invited to participate in a follow-up interview about health care utilization and family impact of migraine; 246 (60.0%) participated.


RESULTS
The 1-year prevalence of migraine was 17.2% in females and 6.0% in males. Prevalence was highest between the ages of 30 and 49. Whereas 48% of migraine sufferers had seen a doctor for headache within the last year (current consulters), 31% had never done so in their lifetimes and 21% had not seen a doctor for headache for at least 1 year (lapsed consulters). Of current or lapsed consulters, 73% reported a physician-made diagnosis of migraine; treatments varied. Of all migraine sufferers, 49% were treated with over-the-counter medications only, 23% with prescription medication only, 23% with both, and 5% with no medications at all.


CONCLUSIONS
Relative to prior cross-sectional surveys, epidemiologic profiles for migraine have remained stable in the United States over the last decade. Self-reported rates of current medical consultation have more than doubled. Moderate increases were seen in the percentage of migraine sufferers who use prescription medications and in the likelihood of receiving a physician diagnosis of migraine.
Lipton
R B
RB
Department of Neurology, Albert Einstein College of Medicine, and Headache Unit, Montefiore Medical College, Bronx, NY, USA. rlipton@imrinc.com
Scher
A I
AI
Kolodner
K
K
Liberman
J
J
Steiner
T J
TJ
Stewart
W F
WF
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D016012:Poisson Distribution; D015995:Prevalence; D012737:Sex Factors; D014481:United States / Q000453:epidemiology