Migraine: a major debilitating chronic non-communicable disease in Brazil, evidence from two national surveys

Abstract

BackgroundEven though migraine and other primary headache disorders are common and debilitating, major health surveys in Brazil have not included them. We repair this omission by combining data on non-communicable diseases (NCDs) in the Brazilian National Health Survey (PNS) 2013 with epidemiological data on migraine prevalence and severity in Brazil. The purpose is to rank migraine and its impact on public healthh among NCDs in order to support public-health policy toward better care for migraine in Brazil.MethodsData from PNS, a cross-sectional population-based study, were merged with estimates made by the Brazilian Headache Epidemiology Study (BHES) of migraine prevalence (numbers of people affected and of candidates for migraine preventative therapy) and migraine-attributed disability.ResultsMigraine ranked second in prevalence among the NCDs, and as the highest cause of disability among adults in Brazil. Probable migraine accounted for substantial additional disability. An estimated total of 5.5 million people in Brazil (or 9.5 million with probable migraine included) were in need of preventative therapy.ConclusionOn this evidence, migraine should be included in the next health surveys in Brazil. Public-health policy should recognize the burden of migraine expressed in public ill health, and promote health services offering better diagnosis and treatment.

A long-term open-label safety study of galcanezumab in Japanese patients with migraine

“…Migraine has a substantial impact on multiple aspects of an individual's life, including health-related quality of life (HRQoL), day-to-day functioning, absenteeism, and healthcare resource use [1][2][3]. In Japan, the prevalence of migraine is similar to what is reported globally, with approximately 8% of the population affected [4][5][6][7]. Treatment guidelines from the Japanese Society of Neurology and Japanese Headache Society recommend antiepileptic drugs, antidepressants, betablockers, calcium channel blockers, and angiotensin receptor blockers/angiotensin-converting enzyme inhibitors as preventive treatments for migraine [8]; however, none of these drugs specifically target the underlying pathophysiology of migraine and most are not well tolerated, which limits their use [9].…”

Annual indirect costs secondary to headache disability in Brazil

“…† Migraine Disability Assessment Score (MIDAS); disabled population was defined as MIDAS ≥10. This impact threshold includes persons with moderate-to-severely impacted health defined by a headache frequency ≥3 attacks/month, and who are thus eligible for migraine prevention treatment (31); Int$: International Dollar in 2018 (24). TTH: Tension-type headache.…”

“…Moreover, we assumed that the mean days lost/worked with reduced productivity could be extended to the headache population. A more conservative estimate would use only the proportion of disabled people according to the MIDAS ≥10 criterion for each headache subtype (31). On the other hand, as discussed in an early review on the topic (11), these surveys do not estimate costs from job loss/retirement due to headache disorders.…”

“…It is well known that primary headache prevalence peaks in people's most productive years; that is, around the 30s-40s decades of life (2,4,15,16,31). Recent data from the Global Burden of Diseases study found that migraine and tension-type headache-related disability (measured as years lived with disease, YLD) peaks between 35-39 years (3).…”

Internações por enxaqueca:

“…Por ser um desconforto um tanto quanto frequente, há uma ideia, no senso comum, de que a enxaqueca pode ser resolvida com um simples analgésico e, por isso, a população é levada, gradativamente, a automedicação de madeira demasiada e, sem perceber, pode gerar mais danos a sua condição clínica, chegando a uma situação que gere a internação. Alguns autores referem que 13,4% dos migranosos procuram unidades de emergência, ao menos uma vez, devido à cefaleia 14,15,16 .…”