Chronic migraine in the population: burden, diagnosis, and satisfaction with treatment.
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.


CONCLUSIONS
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.
Bigal
Marcelo E
ME
Merck Research Laboratories, 1 Merck Drive, Whitehouse Station, NJ 08889, USA. marcelo_bigal@merck.com
Serrano
Daniel
D
Reed
Michael
M
Lipton
Richard B
RB
D000041:Absenteeism; D000203:Activities of Daily Living; D000208:Acute Disease; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002908:Chronic Disease; D015331:Cohort Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data; D004185:Disability Evaluation; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D004366:Nonprescription Drugs / Q000627:therapeutic use; D017060:Patient Satisfaction; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014363:Tryptamines / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
D000700:Analgesics; D000701:Analgesics, Opioid; D000927:Anticonvulsants; D004366:Nonprescription Drugs; D014363:Tryptamines