Conference Coverage

Chronic migraine affects education, employment, and income



PHILADELPHIA – People with chronic migraine have higher levels of headache-related disability and unemployment and under-employment, which correspond to lower personal and household income.

Demographic findings of the CaMEO (Chronic Migraine Epidemiology and Outcomes) study confirm that chronic migraine exerts serious, long-lasting effects on personal and family well-being, Dr. Richard Lipton said at the annual meeting of the American Academy of Neurology.

Dr. Richard Lipton

CaMEO was a 13-month, Web-based survey that garnered input from almost 81,000 people who reported headache within the past year, said Dr. Lipton, director of the Montefiore Headache Center, Bronx, New York.

They completed a validated questionnaire that used diagnostic questions from the International Classification of Headache Disorders system to identify episodic migraine (less than 15 headache days/month) and chronic migraine (more than 15 headache days/month). After the initial assessment, they completed additional assessments every 3 months for the duration of the study.

Of the entire study population, 16,789 (21%) were found to have migraine. Of those, 1,476 (8.8%) had chronic migraine (CM). The rest had episodic migraine (EM).

Mean ages were similar in both groups (41 years). Those with CM were significantly more likely to be female (81% vs. 74%), obese (42% vs. 35%), and white (88% vs. 83%). The mean score on the MIDAS (Migraine Disability Assessment) test, a measure of headache-related disability, was significantly higher (worse) for those with CM (61 vs. 13).

Chronic migraine was associated with a significantly lower educational level, with 35% having at least a bachelor’s degree, compared with 46% of those with EM (odds ratio, 0.63). Full- or part-time employment was less common among those with CM (56% vs. 66%; OR, 0.66).

There were also significant differences in annual income. At every income level, those with CM had significantly higher odds of making less than did those with EM (OR, 0.65). People with CM also were significantly more likely to have low household income (OR, 0.63).

"The CM group was more likely to have individual incomes of less than $50,000/year (79% vs. 69%) and household incomes of less than $50,000 year (50% vs. 39%)," Dr. Lipton said.

"We have previously shown that people from low-income households and low educational backgrounds have a higher incidence of migraine onset," Dr. Lipton said. "This suggests there are some factors associated with low income, stressful life events, or even family history – you might come from a low-income family because your parents had migraine that was disabling to them."

In addition to baseline characteristics, the study is looking at barriers to care; migraine phenotypes and comorbidities; and family burden on both spouses and children.

Allergan Inc. sponsored the study. Dr. Lipton has received honoraria from the company.

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