Dr Faraidoon Haghdoost Explains Results of COVID-19 Migraine Triggers, Frequency Study

There can be a myriad of reasons for the patterns observed in our study on alteration of migraine frequency and triggers during the pandemic, 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®): In your study, you found migraine frequency increased during the coronavirus disease 2019 (COVID-19) pandemic, but reports of the 4 most common triggers decreased. What accounts for these results?

Dr. Haghdoost: There can be lots of reasons for these patterns. About the triggers, stress generally decreased, the percentage of stress as a trigger, not in general. I think the phone application is like that. The patients report a headache and there are some questions. Is there any trigger related to your headache that you are reporting? And there are lots of options that they can select. Another question is, what is the severity of your headache? How was the duration, questions like that. Stress as a trigger had lower percentages compared to previous years, anxiety didn't change that much. Lack of sleep decreased as a trigger. This pattern is interesting. It's kind of just a cross-sectional study that the only thing that this study can tell us is, there is a pattern. What's the reason? We don't know, we have to check for it. These data are from different countries, mostly, the users were from the United States, about 50%, 45%. And data are from other countries like the United Kingdom, Canada, France, Germany, Australia, and several different countries. We don't know what the difference is between countries at the moment. Maybe we have to check it. So there are lots of explanations for these. Maybe there are some other triggers that we have where the percentage is low, but it's increasing. These have effects on the pattern, but we don't see them at the moment. Or maybe now the new users, what I was thinking about is, at the beginning in 2018, mostly, maybe patients who had other comorbidities like stress anxiety, were interested in using the phone application. But now at the moment, more patients even without comorbidities are interested, for example.

We need to check several different factors and adjust for everything, do subgroup analyses, for different countries, different times. We know that the COVID-19 pandemic was considered a pandemic in March 2020, I think. Our data is for April, January, February, and March. I think we have to continue this study to see maybe there is a new pattern, there is a difference now after March. Even what I'm thinking about is, maybe we should do another study; have a sample of the users and send them questionnaires, do migraine diagnoses based on, for example, a migraine-specific screening questionnaire, which is a simple questionnaire and ask several questions, the same questions, and have the real responses and compare different groups together, compare different countries, different times. That's what may help in the future.