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Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey.

ABSTRACT: OBJECTIVES:To quantify the social burden among Japanese migraine patients in the context of currently available migraine treatments, by comparison with non-migraine controls, and comparison of migraine patients currently taking prescription medication versus not taking prescription medication. DESIGN:Cross-sectional analysis. SETTING:Data from the population-based online self-administered Japan National Health and Wellness Survey (NHWS) 2017. PARTICIPANTS:Respondents to the NHWS (n=30?001) were ?18 years. Migraine patients were respondents with self-reported experience and physician diagnosis of migraine. Non-migraine controls reported no migraine experience. Migraine patients were subgrouped into currently taking prescription medication for migraine (Rx) and currently not taking prescription medication (non-Rx). METHODS:One-way analysis of variance tests were performed to compare health-related quality of life (HRQoL), work productivity and activity impairment and healthcare resource utilisation between migraine patients and matched non-migraine controls selected by 1:1 propensity score matching. Generalised linear models were used to compare outcomes and migraine related characteristics between Rx and non-Rx. RESULTS:Compared with matched controls, migraine patients (n=1265) had significantly lower HRQoL in terms of lower Physical Component Summary (48.36 vs 51.29, p<0.001), Mental Component Summary (44.65 vs 48.31, p<0.001), Role/Social Component Summary (41.78 vs 46.18, p<0.001) and mean EuroQol 5-Dimension index (0.77 vs 0.86, p<0.001) scores. Migraine patients experienced significantly higher absenteeism (6.95% vs 3.07%, p<0.001), presenteeism (32.73% vs 18.94%, p<0.001), work productivity loss (34.82% vs 20.03%, p<0.001) and daily activity impairment (35.70% vs 22.04%, p<0.001) and visited healthcare professionals more often (8.38 vs 4.57, p<0.001) than controls. No significant differences in these outcomes were found when comparing Rx (n=587) and non-Rx (n=678) patients. CONCLUSIONS:There is an unmet need for improved HRQoL and work productivity in Japanese migraine patients despite the currently available prescription medications, which are important factors to consider for future development of migraine therapies.

SUBMITTER: Igarashi H

PROVIDER: S-EPMC7654137 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey.

Igarashi Hisaka H Ueda Kaname K Jung Sungeun S Cai Zhihong Z Chen Yirong Y Nakamura Tomomi T

BMJ open 20201109 11

<h4>Objectives</h4>To quantify the social burden among Japanese migraine patients in the context of currently available migraine treatments, by comparison with non-migraine controls, and comparison of migraine patients currently taking prescription medication versus not taking prescription medication.<h4>Design</h4>Cross-sectional analysis.<h4>Setting</h4>Data from the population-based online self-administered Japan National Health and Wellness Survey (NHWS) 2017.<h4>Participants</h4>Respondents ...[more]

PMID: 33168555

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Project description:IntroductionPrior studies have estimated the burden of migraine in patients suffering from ≥ 4 monthly headache days (MHDs), but the burden experienced by migraineurs suffering from one to three (1-3) MHDs is unknown. The aim of this study was to examine the incremental burden of migraine in terms of health-related quality of life (HRQoL), impairments to work and daily activities, and healthcare resource utilization (HRU) in five European countries (France, Germany, Italy, Spain, and the UK (EU5]), by comparing migraineurs with ≥ 4 MHDs and migraineurs with 1-3 MHDs.MethodsThe sample for this retrospective cross-sectional study was collected from the 2017 National Health and Wellness Survey (N = 62,000). The Short-Form 12-Item Health Survey Instrument, version-2 physical and mental component summary (PCS and MCS) scores, Short-Form 6-dimensions (SF-6D), EuroQoL 5-dimensions (EQ-5D) and EuroQoL visual analog scale (VAS) scores, impairments to work productivity and daily activities (Work Productivity and Activity Impairment [WPAI] Questionnaire) scores, and HRU were compared between migraineur groups with ≥ 4 MHDs (4-7, intermediate-frequency episodic migraine; 8-14, high-frequency episodic migraine; ≥ 15 chronic migraine) and the migraineur subgroup with 1-3 MHDs (low-frequency episodic migraine) using generalized linear modeling after adjusting for covariates.ResultsData from a total of 62,000 survey respondents were examined, of whom 1323 and 1569 were considered to have 1-3 MHDs and ≥ 4 MHDs (4-7 MHDs [n = 783]; 8-14 MHDs [n = 429]; ≥ 15 MHDs [n = 357]), respectively. The adjusted HRQoL was significantly lower in the 4-7 MHDs (for MCS and SF-6D scores; p < 0.0001) and 8-14 MHDs subgroups (for MCS, SF-6D, EQ-5D, and EuroQoL VAS scores, p < 0.0001; for PCS scores, p = 0.0007) than in the 1-3 MHDs subgroup. Migraineurs with 4-7 and 8-14 MHDs reported higher activity impairment and more frequent visits to healthcare providers (all p < 0.0001) and neurologists (p = 0.0006 and p < 0.0001, respectively) compared to the 1-3 MHDs subgroup. Migraineurs with ≥ 15 MHDs had significantly lower HRQoL and increased WPAI scores and HRU than the 1-3 MHDs subgroup.ConclusionsThis study provides evidence supporting the incremental burden of migraine, characterized by poorer HRQoL and increased WPAI scores and greater HRU, among migraineurs experiencing ≥ 4 MHDs compared with migraineurs experiencing 1-3 MHDs in the EU5.

Project description:OBJECTIVE:The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers. DESIGN:A cross-sectional online survey. PARTICIPANTS:4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities. PRIMARY OUTCOME MEASURES:Informal care costs and out-of-pocket payments for long-term care (LTC) services. RESULTS:From 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a ?² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers' employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs. CONCLUSION:This study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers' employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.

Project description:ObjectivesTo assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan.MethodsWe conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic.ResultsFinally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic.ConclusionsIn this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

Project description:BackgroundElderly social isolation could be prevented by facilitating communication or mutual helping at the neighborhood level. The helping of elderly neighbors by local volunteers may relate to their community commitment (CC), but ways to measure CC have not been identified. The aim of the present study was to develop a Community Commitment Scale (CCS) to measure psychological sense of belonging and socializing in the community among local volunteers, for research in prevention of elderly social isolation. We also tested the CCS in a general population of the elderly.MethodsA pilot test of 266 Japanese urban residents was conducted to examine face validity for 24 identified items, of which 12 items were selected for the CCS, based on a 4-point Likert-type scale. The CCS was developed via self-report questionnaires to 859 local volunteers in two suburban cities and to 3484 randomly sampled general residents aged 55 years or older living in one of the cities. To assess concurrent validity, data were collected using the Brief Sense of Community Scale (Peterson; 2008) and two types of single questions on self-efficacy for helping elderly neighbors.ResultsItem analysis and factor analysis identified 8 items, which were classified between two datasets under the domains of "belonging" and "socializing" in the local volunteers and the general residents. Cronbach's alpha (which conveyed the internal consistency of the CCS) was 0.75 in local volunteers and 0.78 in general residents. The correlation coefficients between the scores of the CCS and BSCS were 0.54 for local volunteers and 0.62 for general residents. ANOVA comparing the CCS between the confidence levels of the two types of single question of self-efficacy on helping elderly neighbors showed a strong relationship in the volunteers and residents.ConclusionsThese results demonstrate acceptable internal consistency and concurrent validity for the CCS, with the two dimensions "belonging" and "socializing", among the local volunteers and general residents in urban Japanese areas. Community commitment measured by the CCS was related to the degree of confidence for self-efficacy in helping elderly neighbors to prevent elderly social isolation.

Dataset Information

Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey.

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Social burden of people with the migraine diagnosis in Japan: evidence from a population-based cross-sectional survey.

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