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Yıl:2021; Cilt: 58; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2021;58(2):115-120
Migrenin Yükü ile Yaşamak: “My Migraine Voice” Anketinin TürkiyeSonuçlarının Analizi
AÇ Atalar , M Bozkurt , Z Çalışkan , P Vo , M Ertaş , B Baykan
İstanbul Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Migren sık rastlanan, toplum ve birey açısından ciddi sosyal ve ekonomik kısıtlılık yaratan, kronik nörolojik bir hastalıktır. Bu çalışmada amaç, sık ataklı migreni olan (≥4 migren başağrılı gün/ay), mevcut profilaktik tedavilerden fayda görmemiş bireylerde, 31 ülkede online platformda uygulanmış olan, migreninin bireysel ve toplumsal yükünü araştırma amaçlı “My Migraine Voice” isimli anket çalışmasının Türkiye verilerini irdelemektir. Yöntem: Önceden belirlenen kriterler dahilinde (%90 hasta koruyucu tedavi kullanmış olmalı ve bunların %80’i tedaviyi değiştirme ihtiyacı duymuş olmalı), son 3 ay içerisinde, ayda ≥4 gün migren tipi başağrılı günü olan hastalara 88 soruluk online anket uygulanmıştı. Migren atağının sadece başağrısı değil, ayrıca prodrom ve postdrom fazlarındaki hastalık yükünü belirleme amaçlı sorular ve Genel İş Üretkenliğinde ve Faaliyetlerde Azalma Anketi (WPAI: GH) de çalışmaya dahil edilmişti. Bulgular: Çalışmaya Türkiye’den toplam 237 hasta katılmıştır. Hastaların %62’si migrenin başağrısı fazı sırasında günlük aktivitelerinde aşırı ve çok aşırı derecede kısıtlandıklarını ifade ederken, prodrom ve postdrom fazlarında da sırasıyla %31 ve %34 oranlarında kısıtlılık bildirmişlerdi. Hastaların %28’i 2 yıldan uzun süredir koruyucu tedavi almaktaydı ve bunların sadece %84’ü kullandığı tedaviden tam veya kısmi olarak memnun olduğunu bildirmişti. Bu oran 2 den fazla ilaç ile tedavi başarısızlığı yaşayanlarda %70 lere kadar düşmekteydi. Aktif çalışan hastalarda, migren ağrısı nedeniyle çalışma zamanının %21’i kaybedilmişti ve genel olarak iş gücü kaybı oranı %67 olarak tespit edilmişti. Sonuç: Bu çalışma, migrenin prodrom ve postdrom fazları dahil olmak üzere her evrede, bireyin özel ve profesyonel yaşantısında kısıtlılıklara yol açabileceğini göstermiştir. Gelecekte özellikle mevcut tedavilerden yeterince faydalanamayan hastalara yönelik tedaviler planlanması, yaşam kalitesi ve üretkenliklerinin arttırılabilmesi açısından önem taşımaktadır
Living with Burden of Migraine: The Analysis of “My Migraine Voice” Survey Results in Turkey
Introduction: Migraine is a common, chronic neurologic disease which causes serious social and economical disability at both the individual and the community level. The aim of this study was to interpret the data for Turkey from “My Migraine Voice,” an online survey of individuals suffering from frequent migraine attacks (=4 days/month with migraine headaches) who had not benefited from existing prophylactic therapies, conducted in 31 countries to investigate the burden of migraine for the individual and the society. Methods: Based on a set of predetermined criteria (90% of the patients must have used prophylactic therapy, and 80% of them must have needed to change therapy), patients who had = 4 days in a month with migraine headache in the past 3 months were asked to take an online survey of 88 questions. The study included questions aimed at determining the burden of disease during not only the headache phase, but also the prodrome and postdrome phases, as well as a questionnaire for determining the Reduction of Overall Activity and Productivity at Work ((WPAI: GH). Results: A total of 237 patients from Turkey were included in the study. 62% of the patients stated that they were severely or very severely disabled in their daily activities during the headache phase of migraine, and 31% and 34% of the patients reported that they were disabled during the prodrome and postdrome phases, respectively. 28% of the patients stated they had been receiving prophylactic therapy for more than 2 years, and only 84% of these patients reported complete or partial satisfaction with their current therapies. This value was as low as ~70% in patients in whom 2 or more previous drug treatments or therapies had failed. Actively-working patients reported that they had lost 21% of their time at work due to migraine, and the overall loss of workforce was 67%. Conclusion: This study showed that migraine can cause disability in an individual’s private and professional lives during every stage of migraine, including the prodrome and postdrome phases. This finding will be important for designing future treatments aimed at enhancing the quality of life and productivity of patients who cannot adequately benefit from existing therapies.

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