title: Headache-attributed burden and its impact on productivity and quality of life in Russia: structured healthcare for headache is urgently needed.
abstract: OBJECTIVE
  The study evaluated headache-attributed burden and its impact on productivity and quality of life (QoL) in Russia. Its purpose was to support recommendations for change.
  
  
  METHODS
  A countrywide population-based random sample of 2725 biologically unrelated adults (aged 18-65 years) in 35 cities and nine rural areas of Russia were interviewed in a door-to-door survey. The structured questionnaire enquired into symptom burden, functional disability, lost productive time and QoL (applying the WHOQoL-8 question set), as well as willingness to pay (WTP) for adequate headache treatment, if it were available.
  
  
  RESULTS
  Mean lost paid-work days due to headache in the previous 3 months were 1.9 ± 4.2, and mean lost household work days were 3.4 ± 5.7. The estimated annual indirect cost of primary headache disorders was USD 22.8 billion, accounting for 1.75% of gross domestic product. QoL was reduced by all types of primary headaches. According to WHOQoL-8, it was significantly lower in those with headache on ≥15 days/month than in those with episodic headache (24.7 ± 4.6 vs. 28.1 ± 5.0; P < 0.05) and lower in those with migraine than in those with tension-type headache (TTH) (27.1 ± 4.9 vs. 28.8 ± 5.0; P < 0.05). Average WTP for adequate headache treatment was RUB 455 ± 494 per month (median RUB 300), a sum sufficient in most cases, and correlated with illness severity (higher for headache on ≥15 days/month than for migraine, and for migraine than for TTH).
  
  
  CONCLUSIONS
  Headache is common, burdensome and costly in Russia and, manifestly, poorly mitigated by existing healthcare. Structured healthcare services for headache need to be urgently put in place.
authors: Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany.
authors: I
authors: I
authors: Ayzenberg
authors: Z
authors: Z
authors: Katsarava
authors: A
authors: A
authors: Sborowski
authors: M
authors: M
authors: Chernysh
authors: V
authors: V
authors: Osipova
authors: G
authors: G
authors: Tabeeva
authors: T J
authors: TJ
authors: Steiner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018672:Community Health Planning; D017281:Cost of Illness; D005260:Female; D006261:Headache / Q000191:economics* / Q000453:epidemiology / Q000523:psychology*; D006296:Health Services / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012426:Russia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: burden of disease; chronic daily headache; global campaign against headache; migraine; prevalence; quality of life; tension-type headache