Disorders

Migraine & Headache - 2021

Dr Emma Foster was the recipient of Brain Foundation grant funding in 2021

Migraine & Headache

Migraine & Headache
Headache in Australia
Dr Emma Foster
Monash University, Victoria
Co-Investigators : A/Prof Alessandro Zagami, Dr Elspeth Hutton, Dr Zhibin Chen, A/Prof Zanfina Ademi

Problem. International studies reveal that migraine and medication overuse headache (MOH) are highly prevalent and highly disabling headache disorders. The 2016 Global Burden of Disease (GBD) study places migraine/MOH as the second leading cause of years lived with disability worldwide. The Deloitte Access Economics ‘Migraine in Australia’ Whitepaper estimated that the cost of migraine in Australia at $35.7 billion per year. Unfortunately, robust migraine and MOH data from the Australian general population are completely lacking, and these studies had to use international estimates to fill large gaps where Australian-specific data were not available. The few Australian based epidemiology studies to date have been limited to certain age groups, postcodes, care settings, or have not been designed with the primary intention of collecting migraine data, and therefore have limited generalisability across the Australian general population. Accurate data are desperately needed regarding the prevalence, ictal- and interictal burden of migraine and MOH in Australia. In addition, international studies have demonstrated that multiple barriers may prevent people from accessing optimal migraine and MOH care. For example, one large, multinational study found that only 28% of people seen for the first time in a headache clinic had correctly self-identified their condition as migraine. Another study found that 95.5% of people with chronic migraine had either not consulted a healthcare professional, had not received a correct diagnosis, or had not been commenced on appropriate therapy. Local studies are desperately needed to determine the actual extent of what is likely a major public health issue. This is a critical first step to direct future research, clinical practice, and healthcare policy on headache in Australia.

Solution. We propose a pilot study involving mail drop of internationally validated migraine and MOH questionnaires across 19,445 Australian households.

Aims. This pilot study will assess the feasibility of a questionnaire-based epidemiological study to assess migraine and MOH prevalence, burden, and treatment gaps in a representative sample of the Australian general population in metropolitan and regional Victoria and New South Wales.

Hypotheses. That mail drop questionnaires are an efficient and effective way for conducting a headache epidemiology study in an Australian setting; that migraine and MOH are highly prevalent and leading public health issues in Australia; and that the current clinical pathways involve substantial treatment gaps that contribute to the burden of disease.

Expected outcomes. This project will provide a crucial snapshot of migraine and MOH in Australia. It will raise awareness of the magnitude, impact, and current gaps in the treatment

paradigm of these conditions. This pilot study will serve as an evidence base to attract significant funding from industry, institutions, and government grant-giving agencies for the first Australia-wide, comprehensive study of headache epidemiology.

Significance. This project will have a significant impact in Australia. These data will go towards closing the largest knowledge gap in Australian headache medicine. It would represent the most significant assessment of migraine and MOH in Australia. This research is critical for informing guidelines regarding diagnosis, directing future healthcare priorities, incentivising investment in new therapies, improving equitable access to existing and new treatments, and shaping healthcare pathways that will bring impactful change to individuals, their families, and our communities

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