Quality of Life and Health‐Related Disability in Children With Migraine

Ferracini, Gabriela Natália; Dach, Fabíola; Speciali, José Geraldo

doi:10.1111/head.12251

Cited by 45 publications

(45 citation statements)

References 29 publications

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“…A survey of young patients (age range: 2‐18 years) who attended a children's headache center reported that migraine affects QoL at levels equivalent to or greater than other chronic illnesses of childhood, particularly with respect to school performance and emotional functioning . A separate study found that children with migraine were absent from school activities, did not perform household tasks, and did not participate in leisure activities for 23.9 days, on average, during the last 3 months because of migraine . Notably, children self‐reported a worse emotional QoL but not HRQoL, whereas the parents perceived their general, emotional, and HRQoL to be worse …”

Section: Burden Of Diseasementioning

confidence: 99%

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

2018

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Migraine is one of the most common diseases worldwide and, importantly, a major cause of disability. This translates into a huge clinical and economic burden to individuals and society. Despite existing data on how migraine affects populations, the disease continues to be underdiagnosed and therefore undertreated, so the scale of the public health problem may be underestimated. The impact on the daily lives of patients and their families has also been underappreciated. Clinical and regulatory guidelines are encouraging the use of patient-reported outcome tools (PROs), as these may help in disease management and facilitate physician-patient interactions. In clinical trials in migraine, PRO data are key to evaluating the effects of new therapies on patients, such as disability assessment, productivity, quality of life, and emotional and physical functioning. Digital technologies have enabled the development of ePRO tools, which may play a growing role in the collection of PRO data in the future. Here, we will consider the current view of the burden imposed by migraine on patients and society, illustrate this with two patient case studies, and examine the initiatives underway to use our knowledge to improve our management approaches for the disease.

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Section: Burden Of Diseasementioning

confidence: 99%

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

2018

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“…1, 2 Tension-type headache (TTH) is the most common with prevalence rates ranging from 10 to 25 percent in school-aged children. 3 Migraine headaches are somewhat less common with prevalence ranging from about 3 percent in younger school-aged children to nearly 20 percent in older adolescents.…”

Section: Introductionmentioning

confidence: 99%

What Factors Contribute to Headache-Related Disability in Teens?

Kemper

Heyer

Pakalnis

et al. 2016

Pediatric Neurology

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Background Our aim was to describe the relationship between risk factors, such as stress, depression, and anxiety and potentially protective factors against pediatric headache-related disability, such as mindfulness, resilience, and self-compassion, and to determine teens’ interest in mind-body skills training to help reduce headache-related disability. Methods This was a cross-sectional survey among adolescents seen in an academic neurology clinic reporting four or more headaches monthly using standardized instruments to determine the relationship between putative risk and protective factors as well as physiologic markers of inflammation and vagal tone and headache-related disability. Results Among the 29 participants, 31% were male, the average age was 14.8 years, average headache frequency was 11.6 per month, and the most commonly reported trigger was stress (86%). The only risk or protective factor significantly associated with headache-related disability was depression (r=0.52, P=0.004). Depression was negatively correlated with mindfulness, resilience, and self-compassion (P<0.01 each) and positively correlated with stress, sleep disturbance, and anxiety (P<0.01 each). Biomarkers of vagal tone and inflammation were correlated with each other, but not with headache-related disability or depression. There was strong interest in learning skills like slow, deep breathing practices supported by a smart phone app to reduce stress and the negative impact of headaches on daily life. Discussion Among teens with frequent migraine headaches, depression is the strongest risk factor for headache-related disability. Stress is viewed as a headache trigger, and teens reported wanting to learn simple stress management strategies supported by a smart phone application to help reduce headache-related disability.

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“…2,3 Although previous publications have discussed the management of pediatric migraine in the emergency department (ED), [4][5][6] there is only a single pediatric controlled trial conducted in the ED setting 7 ; therefore, most of the recommendations are based on treatment trials in adults or other non-ED settings with off-label use of medications.…”

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confidence: 99%

A Comparison of Acute Treatment Regimens for Migraine in the Emergency Department

2015

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BACKGROUND AND OBJECTIVES: Migraine headache is a common pediatric complaint among emergency department (ED) patients. There are limited trials on abortive therapies in the ED. The objective of this study was to apply a comparative effectiveness approach to investigate acute medication regimens for the prevention of ED revisits. METHODS:Retrospective study using administrative data (Pediatric Health Information System) from 35 pediatric EDs (2009EDs ( -2012. Children aged 7 to 18 years with a principal diagnosis of migraine headache were studied. The primary outcome was a revisit to the ED within 3 days for discharged patients. The primary analysis compared the treatment regimens and individual medications on the risk for revisit. RESULTS:The study identified 32 124 children with migraine; 27 317 (85%) were discharged, and 5.5% had a return ED visit within 3 days. At the index visit, the most common medications included nonopioid analgesics (66%), dopamine antagonists (50%), diphenhydramine (33%), and ondansetron (21%). Triptans and opiate medications were administered infrequently (3% each). Children receiving metoclopramide had a 31% increased odds for an ED revisit within 3 days compared with prochlorperazine. Diphenhydramine with dopamine antagonists was associated with 27% increased odds of an ED revisit compared with dopamine antagonists alone. Children receiving ondansetron had similar revisit rates to those receiving dopamine antagonists. CONCLUSIONS:The majority of children with migraines are successfully discharged from the ED and only 1 in 18 required a revisit within 3 days. Prochlorperazine appears to be superior to metoclopramide in preventing a revisit, and diphenhydramine use is associated with increased rates of return.WHAT'S KNOWN ON THE SUBJECT: Migraine headaches are a common presenting complaint in emergency departments. Abortive treatment in this setting is not well studied, leading to considerable variation in treatment. The relationship between acute medications and emergency department revisits has not been studied. WHAT THIS STUDY ADDS:Eighty-five percent of children with migraine are successfully discharged from the emergency department; only 1 in 18 children require a return visit. Prochlorperazine is associated with less revisits than metoclopramide, and diphenhydramine use is associated with increased risk of return visits.

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Quality of Life and Health‐Related Disability in Children With Migraine

Abstract: Although migraine was a cause of school absenteeism, most of the children with migraine showed little or no disability regarding daily life activities and their quality of life was similar to that of children without headache.

Cited by 45 publications

References 29 publications

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

What Factors Contribute to Headache-Related Disability in Teens?

A Comparison of Acute Treatment Regimens for Migraine in the Emergency Department

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