Did the COVID-19 Pandemic Alter Migraine Attack Frequency, Triggers?

Compared with 2018 and 2019, data from 2020 show reports of headache frequency increased, despite decreases in reports of the 4 most common migraine triggers, said Faraidoon Haghdoost, MD, a general practitioner and PhD student at The George Institute for Global Health in Sydney, Australia.

Transcript:

The American Journal of Managed Care® (AJMC®): Can you give a brief overview of your work?

Dr. Haghdoost: I'm a general practitioner from Iran. But here in Australia, I'm a PhD student and I'm working on headache disorders, especially migraine. My background is I've worked as a general practitioner, but have done research for about 5 or 6 years on headache disorders. Here, specifically, I'm designing clinical trials and systematic reviews on migrant disease.

AJMC®: How did you conduct your study on migraine headache frequency and attack triggers during the coronavirus disease 2019 (COVID-19) pandemic?

Dr. Haghdoost: I don't know if you have heard about a phone application, which is called Migraine Buddy. Migraine Buddy is a smartphone application. At the moment, they have more than 2 million users, and about 400,000 active users. It is designed to work for migraine patients like a headache diary. But it has lots of other features. It can collect data by sensors, movement of the phone, and lots of surveys. It's a good user friendly phone application for migraine patients. In Australia I think we have about 20 to 25 thousand users. But globally, about more than 2 million users. We decided to check the patterns of the real data, which is reported in the phone application and check if there is any pattern during the year. What we decided was to check the difference between 2018, 2019, and 2020 in terms of changes in headache frequency and for most reported headache triggers. There are lots of other data that can be used, but we were interested in changes in headache frequency and most reported headache triggers, migraine triggers. This data is self reported and migraine diagnosis was self-diagnosed. The patients, they think they have migraine, but based on some surveys, they have seen headache specialists, they have visited neurologists, but it's self diagnosed.

AJMC®: What were the main findings of the study?

Dr. Haghdoost: The main findings were interesting because we found an increase in headache frequency, from 2018 to 2019, and from 2019 to 2020. But on the other hand, the 4 most reported triggers, which were stress, lack of sleep, neck pain, and anxiety, somehow they decreased in percentage. In terms of the participants, we gathered data from the active users and our definition of active users was the users which have reported at least one headache in that month, in January, February, April and March of the mentioned years. In 2018, we had data from nearly about 110,000 users in 2019, about 125,000, and in 2020 150,000. We saw, if more users are reporting their headaches during the years, we had an overall increase in the number of reports, but the percentages showed that the triggers decreased, but the headache frequency increased. Headache frequency was in 2018, about 4.9 headache days per month. But in 2019, it was about 5.2 and in 2020 about 5.4 headache days per month.