Treatment pattern and health care resource utilization for Taiwanese patients with migraine: a population-based study

Wang, Yen-Feng; Wang, Shuu-Jiun; Huang, Yao Hsien; Chen, Yung-Tai; Yen, Yu-Chun; Shia, Ben-Chang; Tsai, Ching-Wen; Chan, Hoi-Fong; Panni, Tommaso; Dell’Agnello, Grazia

doi:10.3389/fneur.2023.1222912

Cited by 4 publications

(5 citation statements)

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“…The rate of triptan use or overuse in our MOH patients was lower than estimates from some studies [ 41 – 43 ], although the trend was consistent with prior reports from Taiwan, which could be attributed to the costs of tritpans and the restrictions on their use, e.g. ≤ 400 mg/month for sumatriptan tablets, by the reimbursement regulations of the Taiwan NHI [ 29 , 44 ]. In the present study, triptan or ergot users scored higher on the LDQ and the SDS.…”

Section: Discussionsupporting

confidence: 87%

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Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache

Wang,

Tzeng,

et al. 2023

J Headache Pain

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Objective The present study aimed to compare sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache (MOH). Methods Consecutive patients with newly diagnosed chronic migraine (CM) with and without MOH based on the Third Edition of International Classification of Headache Disorders (ICHD-3) were enrolled prospectively from the headache clinic of a tertiary medical center. Demographics and clinical profiles were collected by using a questionnaire, which included current use of tobacco, alcohol, and caffeinated beverages, the Leeds Dependence Questionnaire (LDQ), the Severity of Dependence Scale (SDS), the Headache Impact Test-6 (HIT-6), and the Pittsburgh Sleep Quality Index (PSQI). Results In total, 1419 CM patients (1135F/284 M, mean age 41.7 ± 13.9 years) were recruited, including 799 with MOH (640F/159 M, mean age 42.5 ± 13.2 years) (56.3%). Smoking was associated with an increased risk for MOH in men (odds ratio [OR] = 3.60 [95% confidence interval = 1.73–7.50], p = 0.001), but not in women (OR = 1.34 [0.88–2.04], p = 0.171) (p = 0.021 for interaction). Hypnotic use ≥ 3 days/week was a risk factor for MOH (OR = 2.55 [95% confidence interval = 2.00–3.24], p < 0.001), regardless of sex. By using receiver operating characteristics (ROC) curves, the cutoff scores of the LDQ for MOH were determined at 7 for women and 6 for men, and those for the SDS were 5 and 4, respectively (area under curve all ≥ 0.83). Among patients with MOH, the male sex was associated with a shorter latency between migraine onset and CM onset (12.9 ± 11.1 vs. 15.4 ± 11.5 years, p = 0.008), despite less average headache intensity (6.7 ± 1.9 vs. 7.2 ± 1.9, p = 0.005), functional impacts (HIT-6: 63.4 ± 8.3 vs. 65.1 ± 8.0, p = 0.009), and sleep disturbances (PSQI: 10.9 ± 4.4 vs. 12.2 ± 4.3, p = 0.001). Conclusions The current study identified an association between smoking and MOH in men, as well as sex-specific cutoffs of the LDQ and the SDS, for MOH. MOH was characterized by a shorter latency between migraine onset and CM onset in men and a more severe phenotype in women. Sex should be considered as an important factor in the evaluation of MOH.

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Section: Discussionsupporting

confidence: 87%

“…Although a referral mechanism is included in the Taiwan NHI, it is not mandatory. Most of the medical expenses are reimbursed, and copayment associated with direction consultations with specialists, even in tertiary medical centers, without referral is typically minimal [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache

Wang,

Tzeng,

et al. 2023

J Headache Pain

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“…The migraine assessment was conducted using two self-assessment measures to evaluate the impact of migraine: the Migraine Disability Assessment Score Questionnaire (MIDAS) ( 17 ) and the Headache Impact Test-6 (HIT-6) ( 18 ). MIDAS is a questionnaire that measure headache-related disability over a 3-month period in patients with migraine.…”

Section: Methodsmentioning

confidence: 99%

“…The HIT-6 is a self-report that measures the impact of headache. It comprises six items that assess the adverse impact of headaches on social functioning, role functioning, vitality, cognitive functioning, and psychological distress ( 18 ). Headache impact severity level can be categorized using four headache impact severity categories: (1) little or no impact (49 or less), (2) some impact (50–55), (3) substantial impact (56–59), and (4) severe impact (60–78).…”

Section: Methodsmentioning

confidence: 99%

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Guerra,

Di Giacomo,

Ranieri

et al. 2024

Front. Neurol.

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BackgroundEpisodic migraine (EM) is the second most prevalent neurological disorder worldwide and is responsible for more disability than all other neurological disorders combined. Triggers for the development of migraine include, stress, emotional burden, low blood sugar levels, tobacco, skipped meals, anxious and depressive feelings. Migraine affects both children and adults, occurring three times more frequently in women than in men.ObjectiveThe aim of this study was to evaluate the psychological profile of EM patients and the relationship among negative emotions in EM patients, analyzing self-efficacy measures in pain management.DesignWe performed an observational study in 60 outpatients aged 18–55 years (mean age 33.8; SD ±10.4) with EM.MethodsAll patients have been enrolled at the Headache Center of the San Salvatore Hospital of L’Aquila. The assessment comprised five standardized psychological self-assessments investigating relevant emotional dimensions and pain self-efficacy, along with two questionnaires assessing migraine-related disability. A network analysis of negative emotions was performed to evaluate which emotional traits and relationships play a crucial role in pain coping and management.ResultsOur findings indicate that migraine significantly impairs the quality of life of patients in their daily lives. Over half of the patients reported experiencing severe disability, with negative emotions significantly influencing their ability to cope with pain and maintain productivity during migraine attacks. Dysphoric variables (irritability, interpersonal resentment, and surrender) were correlated with difficulties in emotion regulation ability and with the capacity of engaging in goal-directed behaviors despite experiencing pain. The ability to regulate one’s emotions and manage dysphoria were positively correlated with pain self-efficacy, whereas positive mental health was associated with individuals’ confidence in performing activities despite experiencing pain.ConclusionNegative emotions had a negative correlation with positive mental health and were linked to a lower capacity to carry out daily activities despite experiencing migraine pain. This suggests that psychological interventions could improve mental health and potentially surpassing the effects of pharmacological interventions alone in migraine management. An integrated, patient-centered approach may represent an effective paradigm to address and reduce the burden of migraine, leading to a reduction in healthcare costs.

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“…Migraine is one of the most common diseases globally and is associated with major disability and significant socioeconomic cost [ 1 , 2 ]. Despite its substantial disease burden, there is evidence that migraine is underdiagnosed and undertreated and that the impact of migraine on the daily lives of patients is underappreciated [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Unmet Needs of Patients Living with Migraine in the Gulf Cooperation Council (GCC) Countries

Albilali,

Al-Hashel,

Elchami

et al. 2024

Pain Ther

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The scale of migraine and its impact on the lives of patients in the Gulf Cooperation Council (GCC) countries may be underestimated by healthcare professionals and the public and unmet needs in the provision of migraine medical care may exist. This article reports the key outcomes from a meeting of migraine specialists and their patients organised by the Emirates Neurology Society to learn more about the patient diagnosis and treatment journey and the extent to which migraine affects daily life. Patient stories indicate that the burden of migraine is underestimated, migraine is not generally recognised as a disease, delayed and incorrect diagnoses are common, and that achieving symptom control is often more a question of good luck rather than good management. Disease awareness campaigns are recommended to elevate societal understanding of migraine and reduce stigma toward patients affected by migraine. Recommendations for an improved healthcare system experience for patients affected by migraine include education initiatives targeting patients and physicians as well as initiatives to address gaps in the diagnosis and treatment of migraine.

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Treatment pattern and health care resource utilization for Taiwanese patients with migraine: a population-based study

Cited by 4 publications

References 37 publications

Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache

Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Unmet Needs of Patients Living with Migraine in the Gulf Cooperation Council (GCC) Countries

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