偏头痛患者的急性治疗模式、偏头痛负担和医疗资源使用情况:OVERCOME(欧盟)观察研究的结果

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY Pain and Therapy Pub Date : 2024-04-16 DOI:10.1007/s40122-024-00589-3
Stefan Evers, Grazia Dell’Agnello, Diego Novick, H. Saygin Gonderten, Tommaso Panni, Julio Pascual
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引用次数: 0

摘要

导言:欧洲联盟(欧盟)偏头痛流行病学、治疗和护理观察调查(OVERCOME)是以人口为基础的总体研究计划的一部分,该计划还包括美国和日本。在此,我们报告了西班牙和德国的偏头痛/严重头痛负担以及急性药物和医疗资源使用情况的数据。方法OVERCOME (EU) 是一项在线、非干预性、横断面调查,于 2020 年 10 月至 2021 年 2 月期间在西班牙和德国的成年人中进行。根据健康调查参与者在过去 12 个月中报告的头痛/偏头痛情况,以及根据修改后的《国际头痛疾病分类》第三版标准或自我报告的医生诊断确定为偏头痛的情况,建立了偏头痛总体队列。对偏头痛总队列和中度至重度头痛发作亚队列的数据进行了分析,中度至重度头痛发作亚队列在过去 3 个月中平均疼痛程度≥ 5 分,疼痛持续时间≥ 4 小时,至少因偏头痛导致中度残疾[偏头痛残疾评估(MIDAS)评分≥ 11]。报告严重残疾(MIDAS IV级)、较差的生活质量(QoL;偏头痛专用QoL问卷)和较高的发作间期负担(偏头痛发作间期负担量表-4)的参与者比例随着头痛天数(HDs)/月而增加。大多数参与者(92.5%)表示目前正在使用急性偏头痛/严重头痛药物,但只有39.0%的人使用三苯氧胺。在中度至重度发作亚组(n = 5547)中,48.4%的人使用曲坦类药物,非甾体抗炎药是最常见的急性药物。中度至重度发作亚群还报告说,随着 HDs/month 的增加,患者的 QoL 更差,疼痛和残疾程度更高,但无论 HDs/month 如何增加,约有 60% 的参与者报告说存在严重的发作间期负担。总队列和亚队列中使用三苯氧胺的患者的治疗满意度(六项偏头痛治疗优化问卷)普遍较低。尽管西班牙和德国的指南推荐中度至重度偏头痛发作时使用三苯氧胺,但只有不到一半的参与者使用三苯氧胺;使用三苯氧胺者的治疗满意度普遍较低。新的定制治疗方案可能有助于解决目前急性治疗中尚未满足的需求。
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Acute Treatment Patterns, Migraine Burden, and Healthcare Resource Use in People With Migraine: Results From the OVERCOME (EU) Observational Study

Introduction

The ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) European Union (EU) is part of an overarching population-based study program that also includes the United States and Japan. Here, we report data on the migraine/severe headache burden and the use of acute medication and healthcare resources in Spain and Germany.

Methods

OVERCOME (EU) was an online, non-interventional, cross-sectional survey conducted in adults in Spain and Germany between October 2020 and February 2021. A total migraine cohort was established based on health survey participants who reported headache/migraine in the last 12 months AND identified as having migraine based on modified International Classification of Headache Disorders, third edition criteria OR self-reported physician diagnosis. Data were analyzed for the total migraine cohort and the subcohort with moderate to severe headache attacks, with average pain severity ≥ 5 points, pain duration ≥ 4 h, and at least moderate disability due to migraine [Migraine Disability Assessment (MIDAS) score ≥ 11] over the past 3 months.

Results

Pain of moderate or severe intensity was the most frequent symptom in the total migraine cohort (n = 19,103/20,756; 92.0%). Proportions of participants reporting severe disability (MIDAS Grade IV), poorer quality of life (QoL; Migraine-Specific QoL Questionnaire), and higher interictal burden (Migraine Interictal Burden Scale-4), generally increased with number of headache days (HDs)/month. Most participants (92.5%) reported current acute migraine/severe headache medication use, although only 39.0% were using triptans. In the moderate to severe attacks subcohort (n = 5547), 48.4% were using triptans, with nonsteroidal anti-inflammatory drugs the most common acute medication. The moderate to severe attacks subcohort also reported poorer QoL and greater pain and disability with increasing HDs/month, although severe interictal burden was reported for ~ 60% of participants regardless of HDs/month. Treatment satisfaction (six-item migraine Treatment Optimization Questionnaire) in those using triptans was generally poor in both total and subcohorts.

Conclusion

High migraine-related burden levels were reported, despite use of acute medication. Although triptans are recommended for moderate to severe migraine attacks in Spanish and German guidelines, less than half of participants were using triptans; treatment satisfaction in those using triptans was generally poor. New tailored treatment options may help address unmet needs in current acute treatment.

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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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