Table 3 Studies reporting clinical management of migraine
Citation | Country/region | Study design Study dates | Migraine criteria | Population (n) | Main findings for participants with migraine |
|---|---|---|---|---|---|
China / Mainland | Cross-sectional other: neurological outpatient department 2010 | ICHD-II | 401 patients with migraine | Practice pattern over the past 1 y: • 68.6% of patients had consulted a physician, 13.5% were diagnosed with migraine, 37.2% had not received any diagnosis Treatment over the past 3 mo: • 43.1% had not used analgesics for migraine, 11.7% were using analgesics ≥3 days/wk., none had used triptans, 2.7% had used preventive drugs | |
Liu, 2013 [24] | China / Mainland | Population-based 2009 | ICHD-II | 452 adults with migraine | Practice pattern over the past 1 y: • 52.9% of adults had consulted a physician for headache • 52.7% of adults who had a consultation for headache were undiagnosed • 13.8% were diagnosed with migraine, the remaining were diagnosed with other headache disorders Significant predictors of consultation for migraine were mild, moderate, or severe disability (HALT index) vs minimal HALT (0–5 days lost/3 mo): • Mild 6–10 days lost: adjusted OR 3.4 (95% CI, 1.6–7.4) • Moderate 11–20 days lost: adjusted OR 2.5 (95% CI, 1.2–5.4) • Severe > 20 days lost: adjusted OR 3.9 (95% CI, 1.9–8.1) |
Lu, 2001 [35] | China / Taiwan | Population-based 1997–1998 | > 15 headache days/mo for > 1 mo; > 4-h duration | 108 adults with chronic daily headache | Practice pattern and treatment over the past 1 y: • 57% had consulted a physician for their headache • 41% consulted their family physician, 28% neurologist • 5% were treated with preventive drugs |
China / Taiwan | Population-based 1997–1998 | IHS migraine and modified migraine (IHS + attacks of 2- to 4-h duration) | 328 adults with migraine | Practice pattern over the past 1 y: • 54% had consulted a physician for the headache • 18% of these had been diagnosed with migraine by their physician Treating physicians • 29% general practitioners • 17% internists, 14% ENT specialists, 12% neurologists • 4.9% gynecologists, 4.6% ophthalmologists, 1.2% allergists, 2.7% other | |
Lu, 2006 [37] | China / Taiwan | Cross-sectional other: neurologists in Taiwan NR | NA | 123 neurologists in Taiwan | 31.7% of patients seen were outpatients with migraine Attitudes: • 88.5% reported headache to be an important part of their practice • 40.2% thought headache patients to be time-consuming • 86.9% reported patient satisfaction as an important consideration for treatment • 89.9% thought behavioral therapy to be an important part of treatment Treatment: • 69.9% agreed that preventive medication was indicated for ≥2 migraine attacks/wk., but 12.2% prescribed preventives for patients with ≥14 headaches/mo • Most commonly prescribed drugs were beta-blockers (96.7%), flunarizine (87.0%), tricyclic antidepressants (80.5%), and valproic acid (54.5%) • 32.5% had never prescribed triptans, mostly because of cost (35%) |
Wang, 2008 [39] | China / Taiwan | Cross-sectional other: neurological clinics 2005 | ICHD-II (MOA, MWA, probable) | 755 patients with headache attending a neurology clinic for the first time | 60% were diagnosed by neurologists with migraine 48% had MWA or MOA (ICHD-II) 71% had any migraine type (ICHD-II) of these, 23% were not diagnosed by neurologists as having migraine 57.4% diagnosed with any migraine (ICHD-II) had never been diagnosed with migraine previously |
Wang, 2013 [46] | China / Taiwan | Cross-sectional other: headache clinics 2011 | Neurologist diagnosis / ICHD-II | 331 adults with migraine at neurology clinics | Over the past 3 mo for chronic migraine vs episodic migraine Health care professional evaluation of headache: 85.6% vs 81.7% • General practitioner: 34.3% vs 24.6% • Neurologist/specialist: 79.0% vs 80.6% • Emergency room visits: 21.0% vs 5.5% • Hospital admission: 4.8% vs 0% • Preventive medication: 48.5% vs 31.7% |
Sakai, 1997 [51] | Japan | Population-based NR | IHS migraine and modified migraine (IHS + attacks of 2- to 4-h duration) | 338 adults with IHS-defined or other defined migraine | 69.4% had never consulted a physician for headache 11.6% were aware their headache was migraine 56.8% were taking OTC drugs 5.4% were taking prescription drugs 18.6% were taking OTC and prescription drugs 19.2% were not taking any medication |
Takeshima, 2004 [53] | Japan | Population-based 1999 | IHS | Adults 41 with MWA 301 with MOA | MWA vs MOA Most never consulted a physician for migraine 61.0% vs 71.8% Few continuously consulted a physician for migraine 7.3% vs 5.3% Main reasons for not consulting or not continuing to consult a physician: • Headache not severe enough 35.7% vs 29.3%; 38.5% vs 30.4% • Will improve spontaneously after standing 57.1% vs 56.9%; 30.8% vs 27.5% • OTC medication effective 21.4% vs 53.7%; 23.1% vs 30.4% |
Kotani, 2004 [50] | Japan | Cross-sectional: other NR | IHS | 35 patients with migraine at a general health clinic | Main reasons for not previously seeking medical attention: • 28.6% can endure symptoms without medication • 28.6% OTC medication is effective • 28.6% could not miss work • 25.7% could sleep and wake pain-free |
Suzuki, 2014 [52] | Japan | Community-based 2007–2008 | ICHD-II | 704 employees in Tokyo | 1.3% regularly visited their physicians 59.4% had never consulted with a physician about their headaches The most common reasons (n = 173) for stopping visits to a physician were: told their condition was not fatal (45.1%), unable to get adequate advice from their physician (20.2%), and no time (14.5%) |
Roh, 1998 [59] | South Korea | Population-based 1996 | IHS | 272 adults with migraine | 64.3% used medication for their migraine 92.8% used OTC medication 24.4% had consulted a physician for headache |
Children/adolescents | |||||
Lu, 2000 [36] | China/ Taiwan | Population-based 1998–1999 | IHS | Children 13–15 y, 277 | 72.1% of children used painkillers for their headache 11.5% used painkillers ≥1 d/wk |
Goto, 2017 [48] | Japan | Population-based 2012 | ICHD-IIIβ (unilateral aura not included) | Children 6–12 y, 48 12–15 y, 37 | Elementary school and junior high school students who reported disability due to migraine: • 44.9% and 47.9% had not had a medical consultation for their migraine • 30.6% and 8.3% had not received prescription medication for their migraine |