Among people enduring migraine, the COVID-19 pandemic has led to both positive and negative perceived repercussions, according to study findings published in Headache.

People living with migraine are generally treated with a variety of medications, holistic practices, and changes to lifestyle, all of which have been severely impacted by the COVID-19 pandemic in availability and approach. Prior research on the impact of the pandemic on migraine has not used patient-centered qualitative approaches, according to the researchers. Therefore, they sought to conduct a study that highlights the qualitative effects of COVID-19 on patients with migraine who haven’t contracted the virus.

They performed a retrospective examination of a semi-structured data collection methodology that included 40 individuals (mean 44 years of age; 78% female; 68% White; 53% without a college degree; 45% unemployed) in the US with medically diagnosed migraine (half had 15 or more headache days/month on average, and all participants had at least 2 headache days/month) who had never tested positive for or been diagnosed with COVID-19. Study participants used acute treatments to treat their migraine with 88% currently using preventative therapy.


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Between July and November 2020, all individuals in the study participated in a 90 minute, semi-structured virtual interview that included sections on migraine history, symptomology, and treatment priorities, in addition to a section on the potential impacts of the pandemic on several outcomes. Participants were also encouraged to share any additional migraine impact related to the pandemic. Participants could not sip any screener or sociodemographic questions, however, they could choose “prefer not to answer” as a choice to several questionnaire items.

Examples of the negative impacts of the pandemic for patients with migraine included barriers to treatment, such as disruption to in-person services, difficulty obtaining a new health care provider, delayed and/or backordered prescriptions, and the desire to avoid visiting urgent care centers and emergency departments. Meanwhile, perceived reasons for the increase in migraine attack frequency and severity included disrupted access to preventative treatments, increased stress and anxiety, and less opportunity to engage in preventative behaviors and therapies and challenges with telemedicine. According to the participants, perceived stressors included mask-wearing mandates in public places, lockdowns, restrictions, and other public health policies tied to COVID-19, closures of school dorms, and competition for employment.

More than two-thirds of the participants reported that the pandemic directly impacted migraine-related aspects of life; positive only impacts (2), negative only (12), and both positive and negative (14). Among these 28 individuals, 5 reported migraine frequency decreased and 9 reported an increase in migraine frequency. Medical care was interrupted (9); stress increased (13), improved access to health care (8). No changes in symptoms during and between migraine were noted, and treatment priorities were unchanged.

The researchers noted a series of study limitations, including recruitment bias; insufficient sample size in stratified groups to “robustly detail differences;” variations in public policy pertaining to the pandemic over time and geographic location would lead to varying impacts; and the exclusion of people who contracted the virus.

Overall, the findings revealed that the current pandemic did not alter their perception of priorities related to acute or preventative treatments for migraine. “Respondents also did not report changes in ictal or interictal migraine attack symptoms, but they shared narratives suggesting a reduction in disability of attacks, often related to greater control over one’s schedule, fewer expectations, and the ability to work and/or attend school from home,” the researchers concluded.

Disclosure: Some [or one] study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Buse DC, Gerstein MT, Houts CR, et al. Impact of the COVID-19 pandemic on people living with migraine: results of the MiCOAS qualitative study. Headache. Published online March 16, 2022. doi:10.1111/head.14274