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Fujimoto T, Iwata H, Kobayashi N, Kondo S, Yamaura K. Sex-related differences regarding headache triggered by low barometric pressure in Japan. BMC Res Notes 2024; 17:203. [PMID: 39044304 PMCID: PMC11267689 DOI: 10.1186/s13104-024-06827-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/12/2024] [Indexed: 07/25/2024] Open
Abstract
PURPOSE The prevalence of migraine headache is higher in women. Low barometric pressure is a factor in headache triggering, but sex-related differences have not been identified. The purpose of this study was to examine sex-related differences in headache triggered by low barometric pressure. METHODS Study subjects aged 20-49 years were randomly selected from a research company's (Macromill, Inc.) web panel. Those with chronic migraine or tension-type headache invited to complete a web-based self-administered questionnaire. Logistic regression analysis was performed with the objective variable as the Headache Impact Test-6 (HIT-6) high scores (56 or more) or headache triggered by low barometric pressure. RESULTS Participants were 332 women and 337 men in the headache population. HIT-6 high scores were associated with age at headache occurrence 20 years or younger (OR: odds ratio 1.85, 95% CI: confidence interval 1.15-2.99, p = 0.012) and headache triggered by low barometric pressure (OR 2.11, 95%CI 1.51-2.94, p < 0.001). Headache triggered by low barometric pressure was significantly associated with women (OR 2.92, 95%CI 2.12-4.02, p < 0.001). CONCLUSIONS Headache triggered by low barometric pressure were related to sex-related differences. It was suggested that a sex-specific treatment approach for headache triggering is needed.
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Affiliation(s)
- Takuma Fujimoto
- Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
| | - Hiroki Iwata
- Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
- Keio University Community Pharmacy, Tokyo, Japan
| | - Noriko Kobayashi
- Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
- Keio University Community Pharmacy, Tokyo, Japan
| | - Shingo Kondo
- Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
- Keio University Community Pharmacy, Tokyo, Japan
| | - Katsunori Yamaura
- Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.
- Keio University Community Pharmacy, Tokyo, Japan.
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Ishii R, Sakai F, Sano H, Nakai M, Koga N, Matsukawa M. Quality of life and work productivity and activity impairment among online survey respondents with migraine across a range of headache frequency. Front Neurol 2024; 15:1440733. [PMID: 39045427 PMCID: PMC11263292 DOI: 10.3389/fneur.2024.1440733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
Objective This study aimed to describe the migraine burden and healthcare utilization in the context of headache frequency using nationwide claims data linked to online survey data previously collected in Japan. Background It has been shown that increase in headache frequency can impose greater impact on individuals' daily and social functioning, but migraine burden in those with low-frequency headaches remains largely unknown in Japan. Methods This post-hoc, observational study reported on 674 respondents who were working individuals and their family members aged 19-74 years, responded to an online questionnaire (response rate: 14.1% [21,704 responded/153,545 kencomⓇ registrants]), and were previously classified as having migraine. Disease burden in terms of Migraine-Specific Quality of Life (MSQ) and Work Productivity and Activity Impairment (WPAI) was compared across 0-3, 4-7, 8-14, and ≥ 15 monthly headache days (MHD). Results Among 674 respondents, 419 (62.2%), 148 (22.0%), 61 (9.1%), and 46 (6.8%) had 0-3, 4-7, 8-14, and ≥ 15 MHD, respectively. Of those, 55 (13.1%), 31 (20.9%), 19 (31.1%), and 20 (43.5%) respondents consulted physicians for headaches. Moderate-to-severe impairments in daily activities were reported by 298 (71.1%), 110 (74.3%), 46 (75.4%), and 38 (82.6%) respondents. The proportion of the respondents with WPAI >0% generally increased with increasing headache frequency (presenteeism: 41.7 and 67.5% in respondents with 0-3 and ≥ 15 MHD, respectively; overall work impairment: 44.8 and 72.5%, respectively; and activity impairment: 44.9 and 73.9%, respectively), except for absenteeism (12.4 and 22.5%, respectively). The mean MSQ score declined with increasing MHD (Role function-restrictive: 75.1 and 59.5 in those with 0-3 and ≥ 15 MHD, respectively; Role function-preventive: 85.8 and 75.0, respectively; and Emotional function: 81.9 and 63.6, respectively). Conclusion Based on the Japanese nationwide claims data, quality of life and work productivity decreased with increasing numbers of headache days. Substantial disease burden paired with low levels of healthcare utilization highlights the need for medical or non-medical intervention.
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Affiliation(s)
- Ryotaro Ishii
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Fumihiko Sakai
- Saitama International Headache Center, Saitama Neuropsychiatric Institute, Saitama, Japan
| | - Hiromi Sano
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Osaka, Japan
| | - Masami Nakai
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Osaka, Japan
| | - Nobuyuki Koga
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
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Takeshima T, Hirata K, Igarashi H, Sakai F, Sano H, Kondo H, Shibasaki Y, Koga N. A study to investigate the prevalence of headache disorders and migraine conducted using medical claims data and linked results from online surveys: post-hoc analysis of other headache disorders. BMC Neurol 2024; 24:176. [PMID: 38796414 PMCID: PMC11127369 DOI: 10.1186/s12883-024-03675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/15/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Surveys using questionnaires to collect epidemiologic data may be subject to misclassification. Here, we analyzed a headache questionnaire to evaluate which questions led to a classification other than migraine. METHODS Anonymized surveys coupled with medical claims data from individuals 19-74 years old were obtained from DeSC Healthcare Inc. to examine proportions of patients with primary headache disorders (i.e.; migraine, tension-type headache, cluster headache, and "other headache disorders"). Six criteria that determined migraine were used to explore how people with other headache disorders responded to these questions. RESULTS Among the 21480 respondents, 7331 (34.0%) reported having headaches. 691 (3.2%) respondents reported migraine, 1441 (6.7%) had tension-type headache, 21 (0.1%) had cluster headache, and 5208 (24.2%) reported other headache disorders. Responses of participants with other headache disorders were analyzed, and the top 3 criteria combined with "Symptoms associated with headache" were "Site of pain" (7.3%), "Headache changes in severity during daily activities" (6.4%), and the 3 criteria combined (8.8%). The symptoms associated with headache were "Stiff shoulders" (13.6%), "Stiff neck" (9.4%), or "Nausea or vomiting" (8.7%), Photophobia" (3.3%) and "Phonophobia" (2.5%). CONCLUSIONS Prevalence of migraine as diagnosed by questionnaire was much lower than expected while the prevalence of "other headache" was higher than expected. We believe the reason for this observation was due to misclassification, and resulted from the failure of the questionnaire to identify some features of migraine that would have been revealed by clinical history taking. Questionnaires should, therefore, be carefully designed, and doctors should be educated, on how to ask questions and record information when conducting semi-structured interviews with patients, to obtain more precise information about their symptoms, including photophobia and phonophobia.
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Affiliation(s)
- Takao Takeshima
- Tominaga Hospital, 1-4-48 Minatomachi, Naniwa-ku, Osaka City, Osaka, Japan
| | - Koichi Hirata
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan
| | - Hisaka Igarashi
- Fujitsu Clinic, Kamikodanaka 4-1-1, Nakahara-ku, Kawasaki City, Kanagawa, Japan
| | - Fumihiko Sakai
- Saitama Neuropsychiatric Institute, 6-11-1 Honmachi-higashi, Chuo-ku, Saitama City, Saitama, Japan
| | - Hiromi Sano
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 3-2-27, Otedori, Chuo-ku, Osaka City, Osaka, Japan
| | - Hiroyuki Kondo
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 2-6-14, Konan, Minato-ku, Tokyo City, Japan
- Compliance Department, Otsuka Pharmaceutical Co., Ltd, Tokyo City, Japan
| | - Yoshiyuki Shibasaki
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 2-6-14, Konan, Minato-ku, Tokyo City, Japan.
| | - Nobuyuki Koga
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 463-10 Kagasuno, Kawauchi-cho, Tokushima City, Tokushima, Japan
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Igarashi H, Sano H, Kondo H, Shibasaki Y, Koga N. Characteristics of patients who seek medical attention for headache and those who do not: cross-sectional survey and linked medical claims data analysis in Japan. BMJ Open 2024; 14:e077686. [PMID: 38684248 PMCID: PMC11086280 DOI: 10.1136/bmjopen-2023-077686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE To describe the characteristics of patients who sought medical attention for headache and those who did not. DESIGN This observational study used a cross-sectional online survey and linked medical claims data. SETTING Data from an online self-administered questionnaire survey conducted in November 2020 as well as linked medical claims data spanning December 2017 and November 2020 were provided by DeSC Healthcare Inc. PARTICIPANTS Of 21 480 respondents aged 19-74 years whose sex and age data matched the claims data, 7311 reported experiencing headache. MEASURES Outcomes included participant characteristics, status of medical attention seeking, medication use, quality of life (QOL) measured by Migraine-Specific QOL (MSQ) questionnaire V.2.1 and headache intensity. RESULTS Of the 7311 respondents with headache, 735 sought medical attention and 6576 did not. Compared with those who did not seek medical attention, those who sought medical attention had more frequent headaches (median: 5 days/3 months vs 10 days/3 months in those who did not vs those who sought medical attention, respectively) had lower MSQ score (mean (SD) MSQ total score: 87.6 (13.0) vs 77.1 (18.1)) and were likely to experience moderately severe to severe headache (19.0% (1252/6576) vs 41.2% (303/735)) without headache medication. The inability to tolerate headache (36.5% (268/735)) was a common reason for seeking medical attention. Since the pain was not severe enough, 35.3% (2323/6576) of patients did not seek medical attention. Furthermore, a subgroup of respondents experiencing headache for ≥15 days were uncertain about which hospital or department to attend. CONCLUSIONS Patients typically seek help when the pain becomes unbearable. Still, some of them did not seek medical attention while they were experiencing headache for ≥15 days per month. Therefore, it is important to raise awareness and encourage seeking early medical attention before symptoms and associated burdens become too severe to be managed effectively.
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Affiliation(s)
| | - Hiromi Sano
- Medical Affairs, Otsuka Pharmaceutical Co Ltd, Osaka, Japan
| | - Hiroyuki Kondo
- Medical Affairs, Otsuka Pharmaceutical Co Ltd, Tokyo, Japan
| | | | - Nobuyuki Koga
- Medical Affairs, Otsuka Pharmaceutical Co Ltd, Tokushima, Japan
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Takizawa T, Kitano T, Iijima M, Togo K, Yonemoto N. Treatment patterns and characteristics of patients with migraine: results from a retrospective database study in Japan. J Headache Pain 2024; 25:19. [PMID: 38331739 PMCID: PMC10854051 DOI: 10.1186/s10194-024-01722-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Clinical characteristics and treatment practice of patients with migraine in Japan in real-world setting have not been fully investigated. We conducted a retrospective cohort study using claims database to understand the clinical practice of migraine in recent years and to characterize patients potentially not managed well by current treatment options. METHODS Our study used data from the large claims database maintained by JMDC Inc. Patients with diagnosis of headache or migraine between January 1, 2018, and July 31, 2022, were defined as the headache cohort, and those with migraine diagnosis and prescription of migraine treatments among the headache cohort were included in the migraine cohort. In the headache cohort, characteristics of medical facilities and status of imaging tests to distinguish secondary headache were examined. Treatment patterns and characteristics of patients potentially not managed well by acute/preventive treatment were described in migraine cohort. RESULTS In the headache cohort, 989,514 patients were included with 57.0% females and mean age of 40.3 years; 77.0% patients visited clinics (with ≤ 19 bed capacities) for their primary diagnosis, and 30.3% patients underwent imaging tests (computed tomography and/or magnetic resonance imaging). In the migraine cohort, 165,339 patients were included with 65.0% females and mean age of 38.8 years. In the migraine cohort, 95.6% received acute treatment while 20.8% received preventive treatment. Acetaminophen/non-steroidal anti-inflammatory drugs were most common (54.8%) as the initial prescription for migraine treatment followed by triptan (51.4%). First treatment prescription included preventive treatment in 15.6%, while the proportion increased to 82.2% in the fourth treatment prescription. Among patients with more than 12 months of follow-up, 3.7% had prescription patterns suggestive of risk of medication-overuse headache, and these patients were characterized by a higher percentage of females and a higher prevalence of comorbidities. CONCLUSIONS This study revealed that approximately one-fifth of the patients with migraine visiting medical facilities use preventive drugs. The presence of potential patients at risk of medication-overuse headache and the role of clinics in migraine treatment were also described.
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Affiliation(s)
- Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Kitano
- Health & Venue, Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan.
| | - Masahiro Iijima
- Internal Medicine & Hospital Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
| | - Kanae Togo
- Health & Venue, Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
| | - Naohiro Yonemoto
- Health & Venue, Pfizer Japan Inc., Shinjuku Bunka Quint Building, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan
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Awaki E, Takeshima T, Matsumori Y, Hirata K, Miyazaki N, Takemura R, Osaga S, Tanizawa Y, Komori M. Impact of Migraine on Daily Life: Results of the Observational survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study. Neurol Ther 2024; 13:165-182. [PMID: 38175489 PMCID: PMC10787723 DOI: 10.1007/s40120-023-00569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION The impacts of migraine on daily life, including daily activities and fundamental health indicators (sleep and mental health), have not been described in detail for people with migraine in Japan. METHODS The cross-sectional ObserVational survey of the Epidemiology, tReatment, and Care Of MigrainE (OVERCOME [Japan]) study was conducted between July and September 2020. Impacts of migraine on housework, family/social/leisure activities, driving, and sleep were assessed using questions from the Migraine Disability Assessment (MIDAS), Migraine-Specific Quality-of-Life Questionnaire, and Impact of Migraine on Partners and Adolescent Children scales and questions developed for OVERCOME (Japan). The Migraine Interictal Burden Scale (MIBS-4) evaluated burden on days without headaches. Depression and anxiety were assessed with the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) scales, respectively. Impacts on daily life were also described across MIDAS/MIBS-4 categories. RESULTS Among 17,071 respondents with migraine, 24.8% required assistance with housework at least sometimes. Migraine interfered with relationships, leisure, and social activities at least sometimes for 31.8%, 41.6%, and 18.0% of respondents, respectively. Between headache days, 26.8% of respondents worried about planning social/leisure activities at least sometimes. Among respondents living with family (N = 13,548), migraine also had impacts on participation in and enjoyment of family activities. Among respondents who drove (N = 10,921), 43.9% reported that symptoms interfered with driving at least sometimes. Migraine interfered with sleep and mood at least sometimes for 52.7% and 70.7% of respondents, respectively. PHQ-8 and GAD-7 thresholds for clinical depression and anxiety were met by 28.6% and 22.0% of respondents, respectively. Impact of migraine on daily life increased with increasing severity of MIDAS/MIBS-4 categories. CONCLUSION The burden of migraine on daily activities, sleep, and mental health is substantial for people with migraine in Japan. In clinical practice, it is important to evaluate the impact of migraine on daily life in addition to migraine symptoms.
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Affiliation(s)
- Etsuko Awaki
- Department of Neurology, Saiseikai Sakaiminato General Hospital, Sakaiminato, Japan
| | - Takao Takeshima
- Department of Neurology Headache Center, Tominaga Hospital, Osaka, Japan
| | | | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Naoki Miyazaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Satoshi Osaga
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., 5-1-28, Isogamidori, Chuo-ku, Kobe-shi, 651-0086, Japan
| | - Yoshinori Tanizawa
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., 5-1-28, Isogamidori, Chuo-ku, Kobe-shi, 651-0086, Japan.
| | - Mika Komori
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., 5-1-28, Isogamidori, Chuo-ku, Kobe-shi, 651-0086, Japan
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Barberio J, Hernandez RK, Naimi AI, Patzer RE, Kim C, Lash TL. Characterizing Fit-for-Purpose Real-World Data: An Assessment of a Mother-Infant Linkage in the Japan Medical Data Center Claims Database. Clin Epidemiol 2024; 16:31-43. [PMID: 38313043 PMCID: PMC10838663 DOI: 10.2147/clep.s429246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/13/2023] [Indexed: 02/06/2024] Open
Abstract
Purpose Observational postapproval safety studies are needed to inform medication safety during pregnancy. Real-world databases can be valuable for supporting such research, but fitness for regulatory purpose must first be vetted. Here, we demonstrate a fit-for-purpose assessment of the Japan Medical Data Center (JMDC) claims database for pregnancy safety regulatory decision-making. Patients and Methods The Duke-Margolis framework considers a database's fitness for regulatory purpose based on relevancy (capacity to answer the research question based on variable availability and a sufficiently sized, representative population) and quality (ability to validly answer the research question based on data completeness and accuracy). To assess these considerations, we examined descriptive characteristics of infants and pregnancies among females ages 12-55 years in the JMDC between January 2005 and March 2022. Results For relevancy, we determined that critical data fields (maternal medications, infant major congenital malformations, covariates) are available. Family identification codes permitted linkage of 385,295 total mother-infant pairs, 57% of which were continuously enrolled during pregnancy. The prevalence of specific congenital malformation subcategories and maternal medical conditions were representative of the general population, but preterm births were below expectations (3.6% versus 5.6%) in this population. For quality, our methods are expected to accurately identify the complete set of mothers and infants with a shared health insurance plan. However, validity of gestational age information was limited given the high proportion (60%) of missing live birth delivery codes coupled with suppression of infant birth dates and inaccessibility of disease codes with gestational week information. Conclusion The JMDC may be well suited for descriptive studies of pregnant people in Japan (eg, comorbidities, medication usage). More work is needed to identify a method to assign pregnancy onset and delivery dates so that in utero medication exposure windows can be defined more precisely as needed for many regulatory postapproval pregnancy safety studies.
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Affiliation(s)
- Julie Barberio
- Department of Epidemiology, Emory University, Atlanta, GA, USA
- Center for Observational Research, Amgen, Inc, Thousand Oaks, CA, USA
| | | | - Ashley I Naimi
- Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - Rachel E Patzer
- Department of Epidemiology, Emory University, Atlanta, GA, USA
- Regenstrief Institute, Indianapolis, IN, USA
| | - Christopher Kim
- Center for Observational Research, Amgen, Inc, Thousand Oaks, CA, USA
| | - Timothy L Lash
- Department of Epidemiology, Emory University, Atlanta, GA, USA
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Katsuki M, Matsumori Y, Ichihara T, Yamada Y, Kawamura S, Kashiwagi K, Koh A, Goto T, Kaneko K, Wada N, Yamagishi F. Treatment Patterns for and Characteristics of Headache in Children and Adolescents Aged 6-17 Years in Japan: A Retrospective Cross-Sectional and Longitudinal Analysis of Health Insurance Claims Data. Life (Basel) 2024; 14:96. [PMID: 38255711 PMCID: PMC10820976 DOI: 10.3390/life14010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE To investigate the prescription patterns for patients aged 6-17 years with headaches in the REZULT database. METHODS We cross-sectionally investigated (Study 1) the pattern of prescription and the proportion of triptan overprescription (≥30 tablets/90 d of triptans) among patients diagnosed with headaches in 2020. Next, we longitudinally studied patients (Study 2) for more than two years from the initial headache diagnosis (July 2010 to April 2022). The number of prescribed tablets was counted every 90 days. RESULTS In Study 1, headache diagnoses were assigned to 62,568 of 543,628 (11.51%) patients, and 1524 of 62,568 (2.44%) patients received acute medication. Single nonsteroidal anti-inflammatory drugs and triptans were prescribed to 620/624 (99.36%) and 5/624 (0.80%) of patients aged 6-11 years, respectively, and 827/900 (91.89%) and 91/900 (10.11%) of patients aged 12-17 years, respectively. Triptan overprescription was observed in 11/96 (11.46%) patients, and 5/11 (45.45%) of those patients received prophylactic medication. In Study 2, 80,756/845,470 (9.55%) patients aged 6-17 years were diagnosed with headaches that persisted for at least two years. Over two years, 44/80,756 (0.05%) patients were overprescribed triptans, and 3408/80,756 (4.22%) patients were prescribed prophylaxis on at least one occasion. CONCLUSIONS Based on real-world data, the appropriate use of prophylactic treatment is still problematic. Overprescription of triptans was observed, although the number of patients was small.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | | | - Taisuke Ichihara
- Japan System Techniques Co., Ltd. (JAST), Minato-ku 108-8288, Japan
| | - Yuya Yamada
- Japan System Techniques Co., Ltd. (JAST), Minato-ku 108-8288, Japan
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Tetsuya Goto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Kazuma Kaneko
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Department of Neurology, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Naomichi Wada
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
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Katsuki M, Matsumori Y, Ichihara T, Yamada Y, Kawamura S, Kashiwagi K, Koh A, Goto T, Kaneko K, Wada N, Yamagishi F. Treatment patterns and characteristics of headache in patients in Japan: A retrospective cross-sectional and longitudinal analysis of health insurance claims data. Cephalalgia 2024; 44:3331024231226177. [PMID: 38194504 DOI: 10.1177/03331024231226177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND The present study aimed to investigate prescription patterns for patients aged over 17 years with headaches in the REZULT database. METHODS We conducted a cross-sectional study (Study 1) of the proportion of over-prescription of acute medications (≥30 tablets/90 days for triptans, combination non-steroidal anti-inflammatory drugs (NSAIDs) and multiple types; ≥45 tablets/90 days for single NSAIDs) among patients with headache diagnosed in 2020. We longitudinally studied (Study 2) patients for >2 years from initial headache diagnosis (July 2010 to April 2022). The number of prescribed tablets was counted every 90 days. RESULTS In Study 1, headache was diagnosed in 200,055 of 3,638,125 (5.5%) patients: 13,651/200,055 (6.8%) received acute medication. Single NSAIDs were prescribed to 12,297/13,651 (90.1%) patients and triptans to 1710/13,651 (12.5%). Over-prescription was found in 2262/13,651 (16.6%) patients and 1200/13,651 (8.8%) patients received prophylactic medication. In Study 2, 408,183/6,840,618 (6.0%) patients were first diagnosed with headaches, which persisted for ≥2 years. Over time, the proportion of patients over-prescribed acute medications increased. Over 2 years, 37,617/408,183 (9.2%) patients were over-prescribed acute medications and 29,313/408,183 (7.2%) patients were prescribed prophylaxis at least once. CONCLUSIONS According to real-world data, prophylaxis remains poorly prescribed, and both acute and prophylactic treatment rates for headaches have increased over time.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | | | - Taisuke Ichihara
- Japan System Techniques Co., Ltd (JAST), Minato-ku, Tokyo, Japan
| | - Yuya Yamada
- Japan System Techniques Co., Ltd (JAST), Minato-ku, Tokyo, Japan
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Tetsuya Goto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Kazuma Kaneko
- Headache Outpatient, Suwa Red Cross Hospital, Suwa, Nagano, Japan
- Department of Neurology, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Naomichi Wada
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan
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Karasawa Y, Yamaguchi K, Nakano S, Nozawa K, Iseki M. Barriers to healthcare access in patients with chronic pain or potential migraine in Japan: a cross-sectional internet survey. FRONTIERS IN PAIN RESEARCH 2023; 4:1271438. [PMID: 37854307 PMCID: PMC10579894 DOI: 10.3389/fpain.2023.1271438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/22/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose Chronic pain and migraines often go untreated despite patient- and economic-related burdens (e.g., impaired quality of life and productivity). Understanding the reasons for non-treatment is important to enable interventions aimed at improving care-seeking behaviors. However, reports on disease-specific justifications for nontreatment in Japan are limited. We aimed to determine the barriers to healthcare access in untreated patients with chronic pain or migraines. Patients and methods This was a non-interventional, cross-sectional, internet questionnaire survey of patients with chronic pain or migraines. The primary endpoint was to identify the reasons for untreated chronic pain or migraines. Secondary endpoints included factors associated with healthcare access, including patient background, patient-reported outcomes, and awareness of generic or authorized generic drugs (AG). Results We surveyed 1,089 patients with chronic pain [605 (55.6%) untreated] and 932 patients with migraines [695 (74.6%) untreated] in 2021. The main reasons for not seeking treatment for chronic pain was "my pain is tolerable" and for migraine, "I can manage my pain with over-the-counter drugs." Background factors significantly associated with untreated chronic pain were younger age, less time required to access the nearest medical institution, less pain, higher activities of daily living (ADL) scores, and lower awareness of generic drugs and AG. Among patients with migraine, notable characteristics included being female, having shorter travel times to the nearest medical facility, residing in municipalities with populations under 50,000, experiencing moderate to severe pain, having higher ADL scores, and displaying lower awareness of AG. The AG awareness rate was 2-fold higher in treated patients than in untreated patients. Conclusion Educating patients regarding the risks associated with pain and its underlying causes, availability of inexpensive treatment options, and location of appropriate treatment facilities may increase treatment rates.
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Affiliation(s)
- Yusuke Karasawa
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., Minato-ku, Tokyo, Japan
| | - Keisuke Yamaguchi
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shogo Nakano
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., Minato-ku, Tokyo, Japan
| | - Kazutaka Nozawa
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., Minato-ku, Tokyo, Japan
| | - Masako Iseki
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Evlice A, Genç H, Uluduz D, Baykan B, Bolay H, Unal-Cevik I, Kissani N, Luvsannorov O, Togha M, Ozge A. Secondary headache disorders in Turkey, the Middle East, Asia, and Africa: A cross-sectional, multicenter study. Cephalalgia 2023; 43:3331024231194024. [PMID: 37592903 DOI: 10.1177/03331024231194024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
BACKGROUND This multicenter cross-sectional study aimed to determine the frequency and characteristics of secondary headaches in different geographic regions, including Turkey, the Middle East, Asia, and Africa. METHODS Patients were admitted to the study on a particular day each week for five consecutive weeks between 1 April and 16 May 2022. Before the study, all researchers underwent a constructed briefing about the use and code of the ICHD-3 criteria. The study was conducted in two stages. In the first stage, data on secondary headaches were compared between the regions. In the second stage, the sub-diagnoses of secondary headaches were analyzed only in Turkey. RESULTS A total of 4144 (30.0%) of the 13,794 patients reported headaches as the main symptoms at admission. A total of 422 patients were excluded from the study. In total, 1249 (33.4%) of 3722 patients were diagnosed as having secondary headaches (Turkey [n = 1039], Middle East [n = 80], Asia [n = 51], Africa [n = 79]). The frequency of secondary headaches (Turkey 33.6%, Africa 30.1%, Middle East 35.5%, Asia 35.4%) did not differ significantly between the regions (p > 0.05). The most common subtype of secondary headaches was headache attributed to substances or their withdrawal in all the studied regions. There was a female predominance in all regions, but it was lower in Africa than in Turkey. The severity and density of headaches differed significantly between the regions, with patients from Africa reporting milder pain than patients from other regions. In Turkey, the most common sub-diagnoses of secondary headaches were medication overuse headache, idiopathic intracranial hypertension, and cervicogenic headache. CONCLUSION In the present study, one in three patients with a headache had a secondary headache. Headache attributed to substances or their withdrawal was the most common subtype of secondary headaches in all the studied regions. The female predominance of secondary headaches was lower in Africa than in Turkey. The severity and density of headaches differed significantly between regions, with patients from Africa reporting milder pain.
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Affiliation(s)
- Ahmet Evlice
- Department of Neurology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Hamit Genç
- Department of Neurology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Derya Uluduz
- Department of Neurology, Istanbul University, Cerrahpasa Faculty of Medicine, İstanbul, Turkey
| | - Betul Baykan
- Istanbul University, Istanbul Faculty of Medicine, EMAR Medical Center, İstanbul, Turkey
| | - Hayrunnisa Bolay
- Department of Neurology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Isin Unal-Cevik
- Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Najib Kissani
- Neuroscience Research Laboratory, Marrakesh Medical School, Cadi Ayyad University, Marrakech, Morocco
| | - Otgonbayar Luvsannorov
- Department of Neurology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Mansoureh Togha
- Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
| | - Aynur Ozge
- Department of Neurology, Mersin University Faculty of Medicine, Mersin, Turkey
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Suzuki S, Suzuki K, Shiina T, Haruyama Y, Hirata K. Real-world experience with monthly and quarterly dosing of fremanezumab for the treatment of patients with migraine in Japan. Front Neurol 2023; 14:1220285. [PMID: 37483436 PMCID: PMC10359132 DOI: 10.3389/fneur.2023.1220285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Background The effectiveness of fremanezumab in treating migraine has been demonstrated in randomized controlled trials. However, real-world study results are still limited. Methods We conducted a single-center, observational study that included patients with episodic migraine (EM) and chronic migraine (CM) who received fremanezumab monthly or quarterly over 6-month periods. The primary outcome of this study was to evaluate changes in monthly migraine days (MMD) and responder achievement after treatment with fremanezumab. The secondary aim was to characterize the predictors of responder at 6 months. We also evaluated the effectiveness of fremanezumab in the patients who switched from other calcitonin gene-related peptide (CGRP) monoclonal antibodies, and compared the effectiveness of fremanezumab between the monthly and quarterly dosing groups. One hundred twenty-seven patients with migraine (age, 45.2 ± 12.6 years; 96 women) who received at least one dose of fremanezumab with ≥3 months of follow-up were included. The number of MMD was assessed by headache diary. Results The changes in MMD from baseline at 1, 3, and 6 months were -6.1 ± 4.7, -7.7 ± 4.4, and - 8.5 ± 4.5 days in the total cohort, respectively (p < 0.001). The ≥50%, ≥ 75 and 100% responder rates at 6 months were 67.6, 22.5, and 5.4% in the total cohort, 90.4, 36.5, and 9.6% in the EM group, and 52.2, 14.9, and 1.5% in the CM group, respectively. Fremanezumab was also effective in 35 patients who switched from other CGRP monoclonal antibodies. Quarterly and monthly fremanezumab doses were equally effective in MMD reduction in the EM and CM groups. In the CM group, 65.1% experienced remission to EM after 6 months. Adverse reactions were mild and occurred in 9.5% of total patients. An at least ≥50% reduction in MMD from months 1 to 3 better predicted a ≥ 50% reduction in MMD at 6 months with 90.5% sensitivity and 80.6% specificity (p < 0.001). Conclusion In our real-world study, quarterly and monthly fremanezumab dosing showed both favorable effectiveness and tolerability in patients with migraine.
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Affiliation(s)
- Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
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Mangrum R, Gerstein MT, Hall CJ, Buse DC, Houts CR, McGinley JS, McCarrier KP, Lipton RB, Wirth RJ. Priority acute and preventive migraine treatment benefits: Results of the Migraine Clinical Outcome Assessment System (MiCOAS) qualitative study of people living with migraine. Headache 2023; 63:953-964. [PMID: 37140142 PMCID: PMC10503657 DOI: 10.1111/head.14521] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND There is renewed emphasis on including patients in determining, defining, and prioritizing outcomes for migraine treatment. OBJECTIVES To obtain insights directly from people living with migraine on their priorities for treatment. METHODS A total of 40 qualitative interviews were conducted as part of the Migraine Clinical Outcome Assessment System project, a United States Food and Drug Administration grant-funded program to develop a core set of patient-centered outcome measures for migraine clinical trials. Interviews included a structured exercise in which participants rank-ordered pre-defined lists of potential benefits for acute and preventive migraine therapy. The 40 study participants who reported being diagnosed with migraine by a clinician ranked the benefits and explained their rationale. RESULTS Study participants consistently ranked either pain relief or absence of pain as their top priority for acute treatment. Relief/absence of other migraine symptoms and improved functioning were also prioritized. For preventive treatment, participants prioritized reductions in migraine frequency, symptom severity, and attack duration. Few differences were found between participants with episodic migraine and those with chronic migraine. However, participants with chronic migraine ranked "increased predictability of attacks" much higher than those with episodic migraine. Participants' rankings were influenced by prior expectations and experiences of migraine treatments, which caused many participants to deprioritize desired benefits as unrealistic. Participants also identified several additional priorities, including limited side-effects and reliable treatment efficacy in both acute and preventive treatments. CONCLUSION The results showed the participants prioritized treatment benefits aligned with existing core clinical outcomes used in migraine research, but also valued benefits that are not typically assessed, such as predictability. Participants also deprioritized important benefits when they believed treatment was unlikely to deliver those outcomes.
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Affiliation(s)
- Rikki Mangrum
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
| | - Maya T Gerstein
- Patient Centered Outcomes, Open Health Group, Bethesda, Maryland, USA
| | - Calvin J Hall
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
| | - Dawn C Buse
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
- Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Carrie R Houts
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
| | | | - Kelly P McCarrier
- Patient Centered Outcomes, Open Health Group, Bethesda, Maryland, USA
| | - Richard B Lipton
- Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - R J Wirth
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
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14
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Sakai F, Igarashi H, Yokoyama M, Begasse de Dhaem O, Kato H, Azuma Y, Koh R, Phillips H, Singh N, Craven A, Dodick DW, Miyake H. Diagnosis, knowledge, perception, and productivity impact of headache education and clinical evaluation program in the workplace at an information technology company of more than 70,000 employees. Cephalalgia 2023; 43:3331024231165682. [PMID: 36967710 DOI: 10.1177/03331024231165682] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Migraine is a highly prevalent, disabling, misunderstood, underdiagnosed, and undertreated neurological disease. It is a leading cause of productivity loss in the workplace. METHODS This is the first large-scale company-wide headache education and evaluation program in the workplace. RESULTS 73,432 (90.5%) Fujitsu employees participated. The prevalence of migraine was 16.7%, tension-type headache 40.7%, and cluster headache 0.5%. After completing the training, 82.9% of participants without headache said they would change their attitude towards colleagues with headache disorders and 72.5% of total participants said their understanding of headache changed. The proportion of employees who thought that headache had a significant impact on people's lives increased from 46.8% to 70.6%; 2971 (4.1%) of all participants were interested in a virtual consultation with a headache specialist as part of the program, more than half of whom had not previously consulted for headache. Approximately 14.7 days per year of full productivity per employee with headache were gained resulting in an annual productivity saving per employee of US$4531. CONCLUSION This unique headache workplace program was associated with a high level of participation, an improvement in the understanding of migraine and attitude towards colleagues with migraine, reduction in disability and increased employee productivity, and decreased costs of lost productivity due to migraine. Workplace programs for migraine should be considered for all industry sectors.
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Affiliation(s)
- Fumihiko Sakai
- International Headache Society Global Patient Advocacy Coalition Executive Committee, Saitama International Headache Center, Saitama Neuropsychiatric Institute, Saitama, Japan
| | | | | | - Olivia Begasse de Dhaem
- International Headache Society Global Patient Advocacy Coalition Executive Committee, Hartford HealthCare, Westport, Connecticut, USA
| | - Hirohisa Kato
- Health Promotion Unit at Fujitsu Co. Ltd, Kawasaki, Japan
| | - Yasuhiro Azuma
- Health Promotion Unit at Fujitsu Co. Ltd, Kawasaki, Japan
| | - Rachel Koh
- International Headache Society Global Patient Advocacy Coalition Executive Committee, American Migraine Foundation, Texas, USA
| | - Heather Phillips
- International Headache Society Global Patient Advocacy Coalition Executive Committee, American Migraine Foundation, New York, USA
| | - Nim Singh
- International Headache Society Global Patient Advocacy Coalition Executive Committee, Atria Academy of Science and Medicine, New York, USA
| | | | - David W Dodick
- International Headache Society Global Patient Advocacy Coalition Executive Committee, Atria Academy of Science and Medicine, New York, USA
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Hitoshi Miyake
- Health Promotion Unit at Fujitsu Co. Ltd, Kawasaki, Japan
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15
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Hirata K, Sano H, Kondo H, Shibasaki Y, Koga N. Clinical characteristics, medication use, and impact of primary headache on daily activities: an observational study using linked online survey and medical claims data in Japan. BMC Neurol 2023; 23:80. [PMID: 36809985 PMCID: PMC9942338 DOI: 10.1186/s12883-023-03122-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Limited epidemiological data are available for headache disorders in Japan, and no recent studies have reported the impact of several primary headache disorders in Japan. This study aimed to report the up-to-date epidemiological data and impact of primary headaches on daily activities as well as the use of medical care, clinical features, and pain severity/activity impairment using nationwide data in Japan. METHODS We used anonymized online survey data coupled with medical claims data, from individuals aged 19-74 years old, that were provided by DeSC Healthcare Inc. The outcomes included the prevalence of migraine, tension-type headache, cluster headache, and other headache types stratified by age and sex, use of medical care, clinical features, medication use, and severity of pain/activity impairment. All outcomes were examined separately for each headache type. This is the second paper reported concurrently with this research. RESULTS The study population comprised 691/1,441/21/5,208 individuals with migraine/tension-type headache/cluster headache/other headache types, respectively. The prevalence of migraine and tension-type headache was higher in women than in men but was similar for cluster headache (male vs. female, 1.7% vs. 7.4%, 5.3% vs. 10.8%, and 0.1% vs. 0.1%, respectively). The percentage of individuals with migraine, tension-type headache, cluster headache who had not seen a doctor was 81.0%, 92.0%, 57.1%, respectively. The common headache triggers were fatigue in migraine and tension-type headache, and weather-related phenomena and turning of the seasons in migraine. Common activities refrained from or reduced by headaches were "operating a computer or smartphone", "drinking alcohol", and "going to crowded places" in all three headache types and housework-related activities in women. Among individuals taking medicines, 16.8%, 15.8%, 47.6% with migraine, tension-type headache, and cluster headache reported moderate to severe pain, respectively, and 12.6%, 7.7%, 19.0% reported moderate to severe disability, respectively. CONCLUSIONS This study found various triggers of headache attacks, and daily activities refrained from or reduced by headaches. Additionally, this study suggested that the disease burden in people possibly experiencing tension-type headaches, many of whom had not seen a doctor. The study findings are of clinical value for the diagnosis and treatment of primary headaches.
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Affiliation(s)
- Koichi Hirata
- grid.255137.70000 0001 0702 8004Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan
| | - Hiromi Sano
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 3-2-27 Otedori, Chuo-Ku, Osaka, Japan.
| | - Hiroyuki Kondo
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 2-6-14 Konan, Minato-Ku, Tokyo, Japan
| | - Yoshiyuki Shibasaki
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 2-6-14 Konan, Minato-Ku, Tokyo, Japan
| | - Nobuyuki Koga
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 463-10 Kagasuno, Kawauchi-Cho, Tokushima, Japan
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Takeshima T, Yamamoto Y, Iwasaki K, Ha C, Oishi M, Sato A, Sonoyama Y, Honda N, Niida H, Takeda J. Prevalence, treatment status, medical costs, quality of life, and productivity loss in Japanese adult patients with anemia: a real-world database study. J Med Econ 2023; 26:1386-1397. [PMID: 37849298 DOI: 10.1080/13696998.2023.2271752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
AIMS To investigate the prevalence, treatment status, and effect of anemia on medical costs, quality of life (QOL), and productivity loss in Japan. METHODS This cross-sectional study used a database containing claims, health check-ups, and questionnaire data. Adults with hemoglobin data at 2020 check-ups were included. QOL and productivity loss were evaluated using EuroQol 5-Dimension (EQ-5D) and Work Productivity and Activity Impairment questionnaire data available for a subset of the population. Nationwide anemia prevalence, including both diagnosed as having anemia and undiagnosed but with low hemoglobin levels, were estimated. Treatment status was described by hemoglobin levels. Differences in medical costs, QOL, and productivity loss were compared between individuals with and without anemia. Subgroup analyses were performed using the Charlson Comorbidity Index (CCI). RESULTS The study population included 554,798 individuals. Anemia prevalence was estimated at 15.1% with 55.3% undiagnosed. In patients with anemia, 85.3% were untreated; 79.5% of the treated patients received only oral iron drugs. In patients with anemia, monthly medical costs were ¥17,766 higher, EQ-5D score was 0.0118 lower, and productivity loss was 2.6% higher than in those without anemia. The trends were consistent even in limited patients with CCI = 0. Nationwide annual excess medical costs, deficit QOL, and productivity loss in patients with anemia were estimated at ¥3.32 trillion, 138,000 quality-adjusted life-years, and ¥1.13 trillion, respectively. LIMITATIONS As the study population only included individuals who underwent health check-ups, they may be healthier than general population. Whether the differences in medical costs, QoL, and productivity loss are caused by anemia or other underlying differences in patient characteristics is unclear, given the likelihood of residual confounding. CONCLUSIONS The results suggest that more than half of patients with anemia were undiagnosed and untreated. Patients with anemia had higher medical costs, lower QOL, and greater productivity loss than those without anemia.
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Affiliation(s)
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | - Masahito Oishi
- Data Intelligence Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Asuka Sato
- Data Intelligence Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Yohei Sonoyama
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Natsumi Honda
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Hiromichi Niida
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Sakai F, Hirata K, Igarashi H, Takeshima T, Nakayama T, Sano H, Kondo H, Shibasaki Y, Koga N. Correction: A study to investigate the prevalence of headache disorders and migraine among people registered in a health insurance association in Japan. J Headache Pain 2022; 23:164. [PMID: 36577957 PMCID: PMC9795650 DOI: 10.1186/s10194-022-01529-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Fumihiko Sakai
- Saitama International Headache Center, Saitama Neuropsychiatric Institute, 6-11-1 Honmachi-Higashi, Chuo-ku, Saitama, 338-8577 Japan
| | - Koichi Hirata
- grid.255137.70000 0001 0702 8004Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293 Japan
| | - Hisaka Igarashi
- Department of Internal Medicine, Headache Care Unit, Fujitsu Clinic, 4-1-1 Kamikodanaka, Nakahara-ku, Kawasaki, Kanagawa 211-8588 Japan
| | - Takao Takeshima
- grid.417159.f0000 0004 7413 9582Headache Center, Department of Neurology, Tominaga Hospital, 1-4-48 Minatomachi, Naniwa-ku, Osaka-shi, Osaka, 556-0017 Japan
| | - Takeo Nakayama
- grid.258799.80000 0004 0372 2033Department of Health Informatics, Graduate School of Medicine and School of Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501 Japan
| | - Hiromi Sano
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 3-2-27 Otedori, Chuo-ku, Osaka, 540-0021 Japan
| | - Hiroyuki Kondo
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4, Konan, Minato-ku, Tokyo, 108-8242 Japan
| | - Yoshiyuki Shibasaki
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4, Konan, Minato-ku, Tokyo, 108-8242 Japan
| | - Nobuyuki Koga
- grid.419953.30000 0004 1756 0784Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 463-10 Kagasuno, Kawauchi-cho, Tokushima, 771-0192 Japan
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