Migraine is a common disorder of the nervous system with a range of symptoms, the main one being a painful headache that usually lasts 4-72 hours. Although the causes of migraine are unknown, changes in hormone levels and alcohol intake are common triggers. The greater the frequency of migraines the greater the impact so migraine is often categorized as long term (chronic) and intermittent (episodic), based on the number of attacks. There is no cure for migraine but there are a range of drugs for treating attacks (acute treatments) and to help prevent attacks (prophylactic treatments). Migraine attacks often result in frequent absence from school and work and are estimated to cost the National Health Service about £150 million per year, mostly for prescription drugs and visits to general practice.
Using data from primary care and hospital, this study will describe the characteristics of patients diagnosed with migraine (including whether they have chronic or episodic migraine), evaluate which treatments they are given (acute or prophylactic treatments), how they use health services and the cost associated of this. Better understanding those with migraine will help to improve management of the condition and inform resource allocation decisions within the health service.
Migraine is a common neurological disorder that affects a large proportion of the population. It causes substantial impairment and disability and is associated with significant financial costs to the National Health Service. This cohort study will characterise the migraine population in the United Kingdom, describe drug treatment patterns and pathways, including medication adherence, and quantify health care resource use and direct costs. Data from primary care and hospital (admissions, outpatient, and accident and emergency visits) will be used in this study.
Patients ?18 years of age with an incident diagnosis of migraine will be included. Demographic characteristics, comorbidities, treatment patterns, resource use and costs will be estimated and stratified by acute and prophylactic treatment groups. Treatment adherence will be descried as continuous use, augmentation, switching or discontinuation. Resource use and costs will be estimated for an indicative year (2016/17). As secondary objectives we will also explore the feasibility of distinguishing between chronic and episodic migraine and will assess the agreement and completeness of recording secondary care contact in primary care.
Descriptive statistics (numbers, proportions, averages and ranges) will be presented and rates of health resource use and direct costs will be presented as total and mean per person per year.
Incident diagnosis of migraine or headache
Prophylactic migraine treatment, patterns and pathways
Health care utilisation
o GP consultations
o Referrals to secondary care
o Secondary care attendance (Inpatient, outpatient, A&E)
Chronic and episodic migraine
Acute migraine treatment
Rebecca Ghosh - Chief Investigator - CPRD
Rebecca Ghosh - Corresponding Applicant - CPRD
Alison Williams - Collaborator - Novartis Pharmaceuticals UK Limited
Dee Stoneman - Collaborator - Novartis Pharmaceuticals UK Limited
Eleanor Yelland - Collaborator - CPRD
Kara Gibson - Collaborator - Novartis Pharmaceuticals UK Limited
Rachael Williams - Collaborator - CPRD
Sandra Lopez Leon - Collaborator - Novartis Farmacéutica, S.A., Barcelona
Tarita Murray-Thomas - Collaborator - CPRD
Victoria Hacking - Collaborator - Novartis Pharmaceuticals UK Limited
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation