Real-world treatment patterns and patient-reported outcomes in episodic and chronic migraine in Japan: analysis of data from the Adelphi migraine disease specific programme

Abstract

BackgroundIn Japan, detailed information on the characteristics, disease burden, and treatment patterns of people living with migraine is limited. The aim of this study was to compare clinical characteristics, disease burden, and treatment patterns in people with episodic migraine (EM) or chronic migraine (CM) using real-world data from clinical practice in Japan.MethodsThis was an analysis of data collected in 2014 by the Adelphi Migraine Disease Specific Programme, a cross-sectional survey of physicians and their consulting adult patients in Japan, using physician and patient questionnaires. We report patient demographics, prescribed treatment, work productivity, and quality-of-life data for people with CM (≥15 headache days/month) or EM (not fulfilling CM criteria). In descriptive analyses, continuous and categorical measures were assessed using t-tests and Chi-squared tests, respectively.ResultsPhysicians provided data for 977 patients (mean age 44.5 years; 77.2% female; 94.5% with EM, 5.5% with CM). A total of 634/977 (64.9%) invited patients (600 with EM; 34 with CM) also provided data. Acute therapy was currently being prescribed in 93.7% and 100% of patients with EM and CM, respectively (p = 0.069); corresponding percentages for current preventive therapy prescriptions were 40.5% and 68.5% (p < 0.001). According to physicians who provided data, preventive therapy was used at least once by significantly fewer patients with EM than with CM (42.3% vs. 68.5%, respectively; p < 0.001). Among patients who provided physicians with information on issues with their current therapy (acute therapy: n = 668 with EM, n = 38 with CM; preventive therapy: n = 295 with EM, n = 21 with CM), lack of efficacy was the most frequently identified problem (acute therapy: EM 35.3%, CM 39.5% [p = 0.833]; preventive therapy: EM 35.3%, CM 52.4% [p = 0.131]). Moderate-to-severe headache-related disability (Migraine Disability Assessment total score ≥ 11) was reported by significantly fewer patients with EM than with CM (21.0% vs. 60.0%, respectively; p < 0.001) among patients who provided data.ConclusionsPreventive treatment patterns in people with EM versus CM differ in Japan, with both types of migraine posing notable disease burdens. Our findings demonstrate that more effective migraine therapies are required to reduce the burden of the disease.Electronic supplementary materialThe online version of this article (10.1186/s10194-019-1012-1) contains supplementary material, which is available to authorized users.

Factors associated with insufficient response to acute treatment of migraine in Japan: analysis of real-world data from the Adelphi Migraine Disease Specific Programme

“…The 2014 Japan Adelphi Migraine Disease Specific Programme (DSP) sought to provide a real-world understanding of information on the clinical characteristics, disease burden, and treatment patterns of patients with migraine being treated in clinical practice in Japan. In a recently published first retrospective analysis of Japan Adelphi Migraine DSP data [8], patients being treated for episodic or chronic migraine were found to have unmet needs with current acute and preventive therapy in line with the above-mentioned US survey findings.…”

“…Data were collected cross-sectionally using standardized DSP methodology over the period January to March 2014. Full details of the methodology of DSPs and the primary analysis of DSP data have been reported [8,9].…”

Burden of migraine among Japanese patients: a cross-sectional National Health and Wellness Survey

“…One strength of this study was the use of a validated instrument WPAI to quantify the work impairment among migraine patients in comparison to the nonmigraine population in Japan, as few other studies have used validated tools for work impairment assessment [9][10][11][12][13][14]. Also, previous studies have primarily focused on analyzing HRU and costs related to migraine within the migraine population [37,38]; hence, our study provided a novel point of view in the burden of the healthcare system utilization and costs of migraine in comparison with the non-migraine population.…”

“…Similarly, US studies have found compromised HRQoL, and increased direct and indirect costs among migraine patients compared to non-migraine respondents [7]. However, few studies have investigated the burden of the illness in Japan [9,10].…”

“…Despite various reports summarized above, only limited studies used standard validated scales to measure the impact of migraine on Japanese migraine patients [10]. Additionally, there is lack of evidence demonstrating the burden to Japanese migraine patients compared to the general population without migraine.…”