Clinical characteristics and patient-reported outcomes of chronic and episodic migraine patients at a US tertiary headache center: A retrospective observational study

Zubair Ahmed; Ryan Honomichl; Stephen F Thompson; Joshua M Cohen; Andrew Schuster; Nicolas R Thompson; Brittany Lapin; Belinda L Udeh; Verena Ramirez Campos; Lynda J Krasenbaum; Irene L Katzan

doi:10.1111/head.14527

Clinical characteristics and patient-reported outcomes of chronic and episodic migraine patients at a US tertiary headache center: A retrospective observational study

Headache. 2023 Jul-Aug;63(7):908-916. doi: 10.1111/head.14527. Epub 2023 Jun 14.

Authors

Zubair Ahmed¹, Ryan Honomichl^{2

3}, Stephen F Thompson⁴, Joshua M Cohen⁵, Andrew Schuster², Nicolas R Thompson^{2

3}, Brittany Lapin^{2

3}, Belinda L Udeh^{3

6}, Verena Ramirez Campos⁵, Lynda J Krasenbaum⁵, Irene L Katzan²

Affiliations

¹ Headache Section, Center for Neurologic Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
² Center for Outcomes Research and Evaluation, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
³ Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
⁴ Teva Pharmaceuticals, Parsippany, New Jersey, USA.
⁵ Teva Branded Pharmaceutical Products R&D, Inc., West Chester, Pennsylvania, USA.
⁶ Center for Population Health Research, Cleveland Clinic, Cleveland, Ohio, USA.

PMID: 37314065
DOI: 10.1111/head.14527

Abstract

Objective: To describe differences in clinical and demographic characteristics between patients with episodic migraine (EM) or chronic migraine (CM) and determine the effect of migraine subtype on patient-reported outcome measures (PROM).

Background: Prior studies have characterized migraine in the general population. While this provides a basis for our understanding of migraine, we have less insight into the characteristics, comorbidities, and outcomes of migraine patients who present to subspecialty headache clinics. These patients represent a subset of the population that bears the greatest burden of migraine disability and are more representative of migraine patients who seek medical care. Valuable insights can be gained from a better understanding of CM and EM in this population.

Methods: We conducted a retrospective observational cohort study of patients with CM or EM seen in the Cleveland Clinic Headache Center between January 2012 and June 2017. Demographics, clinical characteristics, and patient-reported outcome measures (3-Level European Quality of Life 5-Dimension [EQ-5D-3L], Headache Impact Test-6 [HIT-6], Patient Health Questionnaire-9 [PHQ-9]) were compared between groups.

Results: Eleven thousand thirty-seven patients who had 29,032 visits were included. More CM patients reported being on disability 517/3652 (14.2%) than EM patients 249/4881 (5.1%) and had significantly worse mean HIT-6 (67.3 ± 7.4 vs. 63.1 ± 7.4, p < 0.001) and median [interquartile range] EQ-5D-3L (0.77 [0.44-0.82] vs. 0.83 [0.77-1.00], p < 0.001), and PHQ-9 (10 [6-16] vs. 5 [2-10], p < 0.001).

Conclusions: There are multiple differences in demographic characteristics and comorbid conditions between patients with CM and EM. After adjustment for these factors, CM patients had higher PHQ-9 scores, lower quality of life scores, greater disability, and greater work restrictions/unemployment.

Keywords: burden; health-care resource use; health-related quality of life; migraine; work impairment.

Publication types

Observational Study

MeSH terms

Chronic Disease
Headache
Humans
Migraine Disorders* / epidemiology
Migraine Disorders* / therapy
Patient Reported Outcome Measures
Quality of Life*
Retrospective Studies

Grants and funding

Teva Pharmaceuticals