Abstract
This study aims to evaluate health state utilities for migraine based on attack frequency from a mixed population sample consisting of migraineurs and non-migraineurs. A cross-sectional questionnaire survey was designed to measure health-related quality of life (HRQOL) in migraine without aura by time trade-off method (TTO). A convenience sample of university students and staff was recruited regardless of having ever experienced migraine or not. Subjects were asked to elicit two hypothetical health states characterised by different migraine frequencies (‘m’: two migraines lasting 4 h each month and ‘w’: each week) within two hypothetical lifetime frames (20 years left to live/lives until the age of 80 years). Utilities were calculated for the four tasks (U20m, U80m, U20w, U20w) and compared amongst subgroups. Overall 180 respondents were included in the analysis. Mean age was 25.6 years (SD 6.4), 128 (71 %) were female and 110 (61 %) were self-reported migraineurs. Mean utilities for two migraines each month were U20m = 0.84 (SD 0.26) and U80m = 0.89 (SD 0.14), and for each week were U20w = 0.79 (SD 0.27) and U80w = 0.83 (SD 0.17), respectively. Self-reported migraineurs and females attached higher mean utilities for U80m and older respondents for U20m, respectively (p < 0.05). To our knowledge, this is the first study that provides HRQOL results measured by TTO methodology for migraine. Utility loss ranged from 0.1 to 0.2 depending on attack frequency. HRQOL impairment of having two migraine attacks per week was found similar to living with low back pain (0.77–0.79).
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Acknowledgments
Authors are grateful to Prof. Adam Oliver (London School of Economics, Department of Social Policy) for his assistance in designing the time trade-off questions, and to Dr. Peep F. M. Stalmeier (Radboud University Medical Centre, Nijmegen, Department of Epidemiology, Biostatistics and HTA) for his comments on the manuscript. We also thank Ida Urbán, undergraduate student (Corvinus University of Budapest) for her help in implementing the web-survey.
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Appendices
Appendix 1 Health state description of migraine
Migraine is an episodic but recurrent headache characterised by strong, pulsating typically unilateral pain, mostly in the frontal and eye region of the head. It is often associated with nausea, vomiting, and sensitivity to light or sound. Migraine attacks can lead to functional impairment and might affect daily activities (e.g. work). For 1–2 days after the migraine attack, patients may feel fatigue, daytime sleepiness, and difficulty in concentrating. On migraine-free days migraine sufferers often worry about when the next attack will strike.
Appendix 2 Survey questions
20-years question (Q20m/w)
Imagine that you suffer from migraines. You typically have two migraine attacks each month/each week and each one lasts for about 4 h. Imagine that you are expected to live for 20 more years with these migraines, after which you will die. There is a pill that you can take, which will relieve the migraines completely, but will also shorten your life. What is the minimum number of years of migraine-free life you would require if you were to take the pill?
80-years question (Q80m/w)
Imagine that you suffer from migraines. You typically have two migraine attacks each month/each week and each one lasts for about 4 h. Assume that you are at the age that you are in reality now, and that you are expected to live until you are 80 years old, suffering migraines as indicated above. How many of the years that you have left would you give up to be free of migraine?
‘m’ corresponds to two migraines each month and ‘w’ corresponds to two migraines each week.
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Rencz, F., Brodszky, V., Péntek, M. et al. Health state utilities for migraine based on attack frequency: a time trade-off study. Neurol Sci 36, 197–202 (2015). https://doi.org/10.1007/s10072-014-1920-4
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DOI: https://doi.org/10.1007/s10072-014-1920-4