RESEARCH – March 2016

Health related quality of life among people with migraine and its assessment

Authors: Kristi Anderson, Marit Pärt, Mart Kals, Sulev Haldre, Maigi Vija, Mark Braschinsky

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Background. Migraine is a debilitating disorder. Tere are numerous questionnaires aimed to measure migraine’s burden and its influence on persons’ health related quality of life (HRQoL). To our best knowledge, no studies ask the question if it is necessary to use a syndrome-specific (headache in general), disease-oriented (migraine) scale, or it is justified to use more universal scales. As many international working groups are developing new scales, the answer to the above question would be informative, providing a clearer direction for the development of new indicators of HRQoL.

Aim. The aim of this study was to compare the results obtained by using diferent questionnaires.

Methods. The study was approved by the Research Ethics Committee of the University of Tartu. It is a non-randomized prospective cross-sectional study in which three questionnaires available and validated in Estonian were used. The HRQoL was measured with the self-administered RAND 36-item Health Survey (RAND-36). To evaluate the impact of headache on the ability to function, the Headache Impact Test (HIT-6) was employed. To determine how severely migraine affects patients’ life, Migraine Disability Assessment Test (MIDAS) was selected. The data was collected prospectively during the period from autumn 2012 to autumn 2014. The participants were native Estonian speakers with the diagnoosis of migraine, who visited the Neurology Clinic of Tartu University Hospital. Exclusion criterion was another important comorbidity that can affect persons` assessment of their HRQoL. The results of RAND-36 were compared with the results obtained for the control group.

Results. One hundred and five consecutive consented migraine patients filled in the questionnaires. The RAND-36 control group consisted of 176 individuals from the Estonian population, matched by age and sex. The scores for the RAND-36 were statistically different between the two groups in all domains with the exception of the general health domain (p = 0.68). Taking into account the level of education, there was no statistically significant difference between the physical function (p = 0.43) and vitality domains (p = 0.06), either. The most significant difference between the groups was found in the mental health and bodily pain domains. Results of RAND-36 correlated with those of HIT-6 and even more strongly with scores for MIDAS.

Conclusions. Since scores for RAND-36 correlated with those for HIT-6 and MIDAS, and considering the fact that generic HRQoL tests are more time-consuming, our suggestion would be to use more migraine specific tests in everyday clinical practice.