Distinctions between chronic, episodic migraine should include health care burden
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Key takeaways:
- Researchers analyzed data from a patient survey to determine outcomes in four distinct migraine subcategories.
- Those with chronic migraine face more stigma, insurance barriers than those with episodic migraine.
SAN DIEGO — Distinctions between burdens faced by those who experience different levels of chronic and episodic migraine should be drawn according to external health care-related factors rather than by symptoms alone, according to a poster.
“The system of classification we have has pretty significant impact for the treatment of patients, this is a diagnosis that has profound implications,” Caroline V. Brooks, MA, a doctoral student in the department of sociology at Indiana University, told Healio at the American Headache Society Annual Scientific Meeting.
Brooks and colleague Beth A. Morton, PhD, sought to examine differences within the health care system between episodic and chronic migraine through those who experience a high degree of disability due to the condition.
They analyzed data from the 2019-2020 Coalition for Headache and Migraine Patients’ Headache Disease Patient Access Survey (CHAMP HDPA), an online patient survey, to examine four migraine types: low-frequency episodic migraine (LFEM), high-frequency episodic migraine (HFEM), chronic migraine (CM) and chronic daily migraine (CDM).From 3,514 initial respondents, 2,065 U.S. residents with a medical diagnosis of migraine (mean age 47.6 years; 91.7% female; 91.4% white) were included for analysis.
The researchers included descriptive and bivariate statistics utilizing chi-square with ANOVAs to examine group differences for 48 separate dependent variables.
Results showed that the differences between LFEM and HFEM were significant enough with respect to disability, insurance issues and stigma to warrant a separate classification in lived experience.
In addition, Brooks and Morton found that making a clear distinction between those who experience CM as opposed to CDM would benefit from patient care as the burdens faced by the latter group are more significant.
Data further showed that insurance barriers and overall stigma from health care professionals are significant burdens across all four migraine subcategories, with those experiencing chronic migraine and chronic daily migraine subject to greater stigma and insurance issues compared with those in the low- or high-frequency episodic migraine categories.
“It’s worth being more nuanced when you’re evaluating the number of headache days per month and acknowledging that just because those people have high-frequency episodic, (they) do not have chronic migraine but still have a high level of need,” Brooks said.