A comprehensive assessment of headache characteristics, management and burden of migraine in comparison with tension type headache in Turkey: Results of a cross-sectional survey of adult patients

Abstract Background: Migraine (MIG) is a common cause of headache and a leading cause of morbidity in Turkey but comprehensive and comparative data evaluating its burden are scarce. The study aimed to describe clinical characteristics and management of MIG and compare MIG with tension type headache (TTH) regarding the burden of disease and healthcare resource utilization. Methods: A total of 1368 patients (aged 18-65 years) with MIG or TTH were surveyed regarding patients’ sociodemographics, headache characteristics, clinical management, burden of disease, quality of life and healthcare resource utilization within the previous 12 months. Data from 1053 patients with definite MIG (dMIG) (n: 924; 87.7%) or definite TTH (dTTH) (n: 129; 12.3%) criteria were analyzed. Results: The frequency and duration of attacks, the number of monthly headache days and of days with analgesic consumption and the severity of headaches were higher in dMIG than in dTTH ( p: 0.005 for the frequency of attacks and p <0.001 for the others). The benefits from acute medications decreased as the monthly headache days increased in dMIG: 70.9% (1-3 days); 35.9% (4-7 days); 22.1% (8-14 days) and 18.1% (>14 days). Only 222 (36.8%) of definite migraineurs who experienced ≥4 monthly headache days were on preventive treatment. Migraine Disability Assessment (MIDAS) scores were higher in dMIG than in dTTH (24.7±40 vs 10.6±12; p <0.001). The negative impact on the quality of life and the economic loss were also higher with dMIG (p<0.001 for both). More patients with dTTH visited a physician in the previous year (86.8% vs 77.6%; p :0.016) but the number of physician visits were higher in dMIG (3.5 ±5 vs 1.7 ± 1; p < 0.001). The groups were comparable regarding the percentage of patients who had a radiological investigation due to headache but patients with dMIG had more brain magnetic resonance imaging and computed tomography scans ( p <0.020 and p<0.003, respectively). Conclusions: It is crucial to timely and correctly diagnosing and optimally managing MIG due to its significant burden. Educational programmes for patients and healthcare providers, adherence and persistence to preventive medications may improve clinical outcomes.