Neurology
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Migraine imposes an enormous health burden on individual headache sufferers and on society. The condition affects about 18% of women and about 6% of men across their lifespan. Because prevalence peaks during the most productive years, between the ages of 25 and 55, migraine is an important cause of lost work time. ⋯ Add to this the indirect costs, in the form of absenteeism and reduced productivity at work, and the overall burden of migraine becomes apparent. Work loss is not uniformly distributed, with the most disabled half of migraineurs accounting for more than 80% of all work loss. Although improvements in health care delivery for migraine may increase direct cost (i.e., drug or medical care), this may be offset by savings in indirect costs (i.e., reduced and lost productivity).
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Review Comparative Study
Evolution of the measurement of quality of life in migraine.
Although headache is among the most common pain complaints seen by physicians, the measurement of health-related quality of life (HRQoL) in headache patients is in its earliest stages. Two types of questionnaire have been used to measure HRQoL in headache sufferers: general and disease-specific instruments. General quality-of-life (QoL) instruments use scales to assess QoL with respect to a number of activities within physical, social, psychological, and behavioral life domains. ⋯ Generic QoL instruments, such as the SF-20 or SF-36, may be more useful to define populations being studied than to measure changes in the population over time. The publication of headache-specific QoL instruments, which have been widely used in clinical trials and have been validated, is awaited. Until such time, the SF-36 will remain the standard measure of QoL in headache.