Co-occurrence of pain syndromes

Affaitati, Giannapia; Costantini, Raffaele; Tana, Claudio; Cipollone, Francesco; Giamberardino, Maria Adele

doi:10.1007/s00702-019-02107-8

Cited by 51 publications

(38 citation statements)

References 193 publications

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“…Among the Finnish My Migraine Voice survey participants rheumatoid arthritis, chronic joint inflammation, fibromyalgia and chronic back pain were reported in almost one fifth (17.8%) of all cases. This finding is in line with previous studies that have shown that migraine is highly comorbid with other chronic pain syndromes [40]. Migraine and other chronic pain syndromes have shown to enhance pain and hyperalgesia in patients with fibromyalgia [40,41].…”

Section: Discussionsupporting

confidence: 92%

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My Migraine Voice survey: disease impact on healthcare resource utilization, personal and working life in Finland

Sumelahti

Sumanen

et al. 2020

J Headache Pain

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Background A global My Migraine Voice survey was conducted in 31 countries among 11,266 adults who suffered from ≥4 monthly migraine days (MMD). The aim of this retrospective observational survey-based study was to analyse the country specific results in Finland in order to understand the impact of migraine based on disease severity. Methods The included participants (3%, n = 338/11,266) were stratified by mean MMDs into 4 ≤ MMD < 8 (n = 133), 8 ≤ MMD < 15 (n = 139) and MMD ≥ 15 (n = 66) subgroups. Comorbidities, migraine-related emotional burden and impact on daily living and work productivity and activity impairment (WPAI) were assessed. Subgroup analysis on healthcare resource utilization (HCRU) due to migraine was assessed by visits to healthcare practitioners (HCPs) during the past 6 months and by hospitalizations and emergency room (ER) visits during the past 12 months. The group difference was tested using the one-way ANOVA and for categorical variables using the Chi-squared test. The association between HCRU and MMD and number of comorbidities was assessed using negative binomial regression analysis. Results Mean age was 44 years, 93% were women and 67% (n = 227) were employed. Chronic migraine (CM, MMD ≥ 15) was reported in 19.5% of the respondents. The negative impact on daily functioning and emotional burden increased significantly by migraine frequency. Mean number of comorbidities was 2.4, and mean number of HCP visits during the previous 6 months was 5.9. Increase in migraine frequency and comorbidities was associated with higher HCRU. Eighty-eight percent of the respondents reported negative impact on working life and 52% experienced overall work productivity impairment. Over previous month, the mean number of missed working days for all respondents was 2.8 days of which 54% were paid sick leave days, and in CM up to 6.0 days and 30%, respectively. Both absenteeism and presenteeism were higher in the CM group. Conclusions The emotional and functional burden was high, and the societal burden increased by frequency and severity of migraine, as shown by higher HCRU and reduced work productivity. There is a need to improve quality of care in migraine and improve migraine management related issues in both healthcare and society in Finland.

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Section: Discussionsupporting

confidence: 92%

“…This finding is in line with previous studies that have shown that migraine is highly comorbid with other chronic pain syndromes [40]. Migraine and other chronic pain syndromes have shown to enhance pain and hyperalgesia in patients with fibromyalgia [40,41]. Cardiometabolic conditions along with several other conditions were also frequent.…”

Section: Discussionsupporting

confidence: 92%

My Migraine Voice survey: disease impact on healthcare resource utilization, personal and working life in Finland

Sumelahti

Sumanen

et al. 2020

J Headache Pain

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“…It is possible that pre-existing neurologic vulnerabilities, such as a history of migraine and/or frank neurologic Lyme disease, are associated with a post-treatment phenotype that encompasses an increase in mood-related symptoms. 38 Although, per the IDSA case definition, we excluded participants with major psychiatric illness, Lyme disease has been associated with a range of neurologic and neuropsychiatric symptoms. 39 Strikingly, although female gender 40 41 and greater exposure to prior stressful life events 42 have both been associated with higher mood symptoms in a number of studies, we did not observe that these participants were any more likely to report heightened mood-related symptoms when faced with similar physical symptom levels.…”

Section: Discussionmentioning

confidence: 99%

Symptom heterogeneity and patient subgroup classification among US patients with post-treatment Lyme disease: an observational study

Yang

Aucott

2021

BMJ Open

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ObjectivesTo identify underlying subgroups with distinct symptom profiles, and to characterise and compare these subgroups across a range of demographic, clinical and psychosocial factors, within a heterogeneous group of patients with well-defined post-treatment Lyme disease (PTLD).DesignA clinical case series of patents.SettingParticipants were recruited from a single-site, Lyme disease referral clinic patient population and were evaluated by physical exam, clinical laboratory testing and standardised questionnaires.ParticipantsTwo hundred and twelve participants met study criteria for PTLD, with medical record-confirmed prior Lyme disease as well as current symptoms and functional impact.ResultsExploratory factor analysis classified 30 self-reported symptoms into 6 factors: ‘Fatigue Cognitive’, ‘Ocular Disequilibrium’, ‘Infection-Type’, ‘Mood-Related’, ‘Musculoskeletal Pain’ and ‘Neurologic’. A final latent profile analysis was conducted using ‘Fatigue Cognitive’, ‘Musculoskeletal Pain’ and ‘Mood-Related’ factor-based scores, which produced three emergent symptom profiles, and participants were classified into corresponding subgroups with 59.0%, 18.9% and 22.2% of the sample, respectively. Compared with the other two groups, subgroup 1 had similarly low levels across all factors relative to the sample as a whole, and reported lower rates of disability (1.6% vs 10.0%, 12.8%; q=0.126, 0.035) and higher self-efficacy (median: 7.5 vs 6.0, 5.3; q=0.068,<0.001). Subgroup 2 had the highest ‘Musculoskeletal Pain’ factor-based scores (q≤0.001). Subgroup 3 was characterised overall by higher symptom factor-based scores, and reported higher depression (q≤0.001).ConclusionsThis analysis identified six symptom factors and three potentially clinically relevant subgroups among patients with well-characterised PTLD. We found that these subgroups were differentiated not only by symptom phenotype, but also by a range of other factors. This may serve as an initial step towards engaging with the symptom heterogeneity that has long been observed among patients with this condition.

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“…29,30 There is therefore a need to comprehensively evaluate and treat coexisting pain conditions in patients with migraine. 30 These results indicate considerable unmet needs in patients with migraine who are being actively treated, including those cycling through different lines of preventive therapy. These research findings are an important contribution to understanding the differences between preventive-naïve and preventive-treated migraine populations.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Outcomes for Migraine in the US and Europe: Burden Associated with Multiple Preventive Treatment Failures

Ford¹,

Nichols²,

Ye³

et al. 2021

CEOR

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Purpose: To evaluate patient-reported outcomes (PROs) among patients with migraine, including those who were preventive-naïve and preventive-treated. Methods: This was a point-in-time, real-world study of patients with migraine in the US and EU5 (France, Germany, Spain, Italy, and UK) and their physicians using data from the Adelphi Migraine Disease Specific Programme (DSP™). Physicians completed patient record forms (PRFs) for the next nine consulting patients with migraine plus a tenth patient, who did not need to be consecutive, for whom prior preventive migraine treatments had failed at least once, in order to achieve oversampling of such patients. Patients were given self-completion (PSC) forms that included the Migraine-Specific Quality of Life Questionnaire v2.1 (MSQ), Migraine Disability Assessment Scale (MIDAS), and Work Productivity and Activity Impairment (WPAI) questionnaire. Populations of interest included preventive-naïve and preventive-treated patients defined by the number of treatment lines (1-2 or 3+ preventive regimens). Continuous variables were compared using t-test or ANOVA if normally distributed and Mann-Whitney if not. Chi-squared was used for categorical variables. Results: During August-December 2017, 615 physicians (359 PCPs, 256 neurologists) completed PRFs for 5785 patients (71% female; mean age 40 (±14) years; 65% in full-or part-time employment). Of these, 2798 completed a PSC (preventive-naïve/1-2/3+ preventive lines, n=1707/1034/57). Preventive-treated patients had a greater patient-reported burden across multiple measures versus preventive-naïve patients. Preventive-treated patients had lower MSQ scores indicating greater functional impairment, higher MIDAS scores indicating greater migraine-associated disability, and higher WPAI scores indicating greater overall work and activity impairment than preventive-naïve patients. The magnitude of difference was greatest for the 3+ preventive-treatments cohort. Patterns were similar in the US and EU5. Conclusion: Among patients with migraine who are preventive-treated, including those with multiple lines of therapy, there remain considerable unmet needs in terms of restoring patient function.

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Co-occurrence of pain syndromes

Cited by 51 publications

References 193 publications

My Migraine Voice survey: disease impact on healthcare resource utilization, personal and working life in Finland

My Migraine Voice survey: disease impact on healthcare resource utilization, personal and working life in Finland

Symptom heterogeneity and patient subgroup classification among US patients with post-treatment Lyme disease: an observational study

Patient-Reported Outcomes for Migraine in the US and Europe: Burden Associated with Multiple Preventive Treatment Failures

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