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Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute
Amaal J Starling1, Roger Cady2,3,4, Dawn C Buse5
1Mayo Clinic, Scottsdale, AZ, USA. Starling.Amaal@mayo.edu.
Insights
Individuals with current high-frequency headache/migraine and acute medication overuse (HFM+AMO) experience more headache days and medication use than those in remission. Both groups show low preventive medication use and express concerns about managing their condition.
Area of Science:
- Neurology
- Public Health
- Patient Experience Research
Background:
- Migraine is a disabling neurologic condition with variable severity and frequency.
- High-frequency headache/migraine and acute medication overuse (HFM+AMO) significantly impacts patients' lives.
- Understanding the patient journey in HFM+AMO is crucial for improving care.
Purpose of the Study:
- To compare the self-reported experiences of adults with current HFM+AMO versus those who previously experienced HFM+AMO but achieved sustained reduction.
- To identify differences in headache frequency, medication use, and patient-reported outcomes between these groups.
Main Methods:
- A US population-based online survey (Harris Poll Migraine Report Card) was conducted.
- Adults with migraine were classified as "current HFM+AMO" (≥8 headache days/month, ≥10 acute medication days/month) or "previous HFM+AMO" (≤7 headache days/month, ≤9 acute medication days/month).
- Survey data included demographics, diagnosis, migraine journey, healthcare provider communication, and treatment patterns.
Main Results:
- Current HFM+AMO patients reported significantly more monthly headache days (15.2) and acute medication days (17.4) compared to previous HFM+AMO patients (4.2 and 4.1, respectively).
- Preventive pharmacologic treatment use was low (15-16%) in both groups.
- Current HFM+AMO patients reported more health concerns, while both groups expressed concerns about disease burden and HCP understanding of mental/emotional health.
Conclusions:
- Acute medication optimization appears key, as other medical interventions did not significantly differentiate current from previous HFM+AMO.
- Low utilization of preventive medications was observed in both groups, indicating a potential area for improvement.
- Addressing patients' mental/emotional health concerns and optimizing both acute and preventive treatments are vital for improving outcomes in migraine care.
Background:
Migraine is a disabling neurologic disease that can fluctuate over time in severity, frequency, and acute medication use. Harris Poll Migraine Report Card was a US population-based survey to ascertain quantifiable distinctions amongst individuals with current versus previous high-frequency headache/migraine and acute medication overuse (HFM+AMO). The objective of this report is to compare self-reported experiences in the migraine journey of adults with HFM+AMO to those who previously experienced HFM+AMO but currently have a sustained reduction in headache/migraine frequency and acute medication use.
Methods:
An online survey was available to a general population panel of adults (≥18 years) with migraine per the ID Migraine™ screener. Respondents were classified into "current HFM+AMO" (within the last few months had ≥8 headache days/month and ≥10 days/month of acute medication use; n=440) or "previous HFM+AMO" (previously had HFM+AMO, but within the last few months had ≤7 headache days/month and ≤9 days/month of acute medication use; n=110). Survey questions pertained to demographics, diagnosis, living with migraine, healthcare provider (HCP) communication, and treatment.
Results:
Participants in the current HFM+AMO group had 15.2 monthly headache days and 17.4 days of monthly acute medication use in last few months compared to 4.2 and 4.1 days for the previous HFM+AMO group, respectively. Overall, current preventive pharmacologic treatment use was low (15-16%; P>0.1 for current vs previous) in both groups. Previous HFM+AMO respondents reported better current acute treatment optimization. More respondents with current (80%) than previous HFM+AMO (66%) expressed concern with their current health (P<0.05). More than one-third of both groups wished their HCP better understood their mental/emotional health (current 37%, previous 35%; P>0.1 for current vs previous) and 47% (current) to 54% (previous) of respondents worried about asking their HCP too many questions (P>0.1 for current vs previous).
Conclusion:
Apart from optimization of acute medication, medical interventions did not significantly differentiate between the current and previous HFM+AMO groups. Use of preventive pharmacological medication was low in both groups. Adults with current HFM+AMO more often had health concerns, yet both groups expressed concerns of disease burden. Optimization of acute and preventive medication and addressing mental/emotional health concerns of patients are areas where migraine care may impact outcomes regardless of their disease burden.
