Migraine in America Symptoms and Treatment (MAST) Study

Baseline Study Methods, Treatment Patterns, and Gender Differences

Richard B. Lipton, Sagar Munjal, Aftab Alam, Dawn C. Buse, Kristina M. Fanning, Michael L. Reed, Todd J. Schwedt, David W. Dodick

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. Background: The MAST Study is a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine. This analysis focuses on the initial cross-sectional survey, conducted beginning in 2016, and is intended to update results from earlier national epidemiologic surveys of people with migraine in the United States. Methods: Respondents to the MAST Study were recruited from a US nationwide online research panel. Stratified random sampling identified a representative cohort of adults (aged ≥18 years). We administered a validated diagnostic screener based on modified ICHD-3 beta criteria to identify individuals with migraine averaging at least 1 monthly headache day (MHD) over the previous 3 months. A baseline assessment evaluated sociodemographic and headache features, patterns of consultation and diagnosis, and use of acute and preventive medications for migraine. Frequency data and chi-square contrasts (P <.05) were used to compare respondents based on gender. Results: Baseline survey data (N = 95,821) identified 18,353 respondents who met criteria for migraine, including 15,133 (women n = 11,049, men n = 4084) reporting at least 1 MHD for the preceding 3 months. The mean age of the sample was 43.1 (13.6) years; 73.0% of respondents were women, and 81.0% were Caucasian. Compared with men, women were younger (46.1 vs 42.0 years; P <.001); had more MHDs (5.6 vs 5.3; P <.001); and were more likely to report moderate or severe headache-related disability (45.9% vs 35.8%; P <.001) and cutaneous allodynia (43.7% vs 29.5%; P <.001). The lifetime rate of medical consultation for headache was 79.8% overall and slightly higher in women than in men. Women were more likely than men to have been diagnosed with migraine (48.3% vs 38.8%, P <.001). While 95.1% of people with migraine currently used acute treatment, the majority (58.9%) used over-the-counter (OTC) drugs to the exclusion of prescription drugs, while 11.3% used exclusively prescription drugs, and 20.5% used both. Among acute prescription medication users, women were more likely than men to take triptans (17.7% vs 14.3%, P <.001), while men were more likely than women to take opioids (14.5% vs 9.2%, P <.001). Oral formulations were used predominately (92.7% of the medication users), but men were more likely to use nasal sprays (13.6% vs 9.4%, P <.001) and injectables (7.9% vs 3.4%, P <.001). Men (14.5%) were also significantly more likely than women (10.4%) to be taking daily oral preventive medication (P <.001). Conclusions: The MAST Study identified a large sample of women and men with migraine from a sampling frame that broadly resembles the US population. Low participation rate increases the risk of response bias, however, comparisons with Census data and prior population studies for the demographic and headache characteristics of the current sample suggest that findings are generalizable to the population of people with migraine. Women had more MHDs than men, and they were more likely to report migraine-related disability and cutaneous allodynia. The lifetime consultation rate for headache was relatively high, but many with migraine symptoms reported never having received a diagnosis of migraine from a healthcare professional. Acute prescription and preventive migraine treatments are underused. Migraine persists as an underdiagnosed and undertreated public health problem in 2018, and there are many opportunities to improve the diagnosis and treatment of people with this painful, disabling condition.

Original languageEnglish (US)
Pages (from-to)1408-1426
Number of pages19
JournalHeadache
Volume58
Issue number9
DOIs
StatePublished - Oct 1 2018

Fingerprint

Migraine Disorders
Headache
Therapeutics
Referral and Consultation
Prescription Drugs
Hyperalgesia
Prescriptions
Tryptamines
Population
Nonprescription Drugs
Nasal Sprays
Skin
Censuses

Keywords

  • allodynia
  • epidemiology
  • gender
  • migraine
  • treatment optimization
  • treatment patterns

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Migraine in America Symptoms and Treatment (MAST) Study : Baseline Study Methods, Treatment Patterns, and Gender Differences. / Lipton, Richard B.; Munjal, Sagar; Alam, Aftab; Buse, Dawn C.; Fanning, Kristina M.; Reed, Michael L.; Schwedt, Todd J.; Dodick, David W.

In: Headache, Vol. 58, No. 9, 01.10.2018, p. 1408-1426.

Research output: Contribution to journalArticle

Lipton, RB, Munjal, S, Alam, A, Buse, DC, Fanning, KM, Reed, ML, Schwedt, TJ & Dodick, DW 2018, 'Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences', Headache, vol. 58, no. 9, pp. 1408-1426. https://doi.org/10.1111/head.13407
Lipton, Richard B. ; Munjal, Sagar ; Alam, Aftab ; Buse, Dawn C. ; Fanning, Kristina M. ; Reed, Michael L. ; Schwedt, Todd J. ; Dodick, David W. / Migraine in America Symptoms and Treatment (MAST) Study : Baseline Study Methods, Treatment Patterns, and Gender Differences. In: Headache. 2018 ; Vol. 58, No. 9. pp. 1408-1426.
@article{4c3e0d8085ef4b66b3e5a5827da12ed9,
title = "Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences",
abstract = "Objectives: To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. Background: The MAST Study is a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine. This analysis focuses on the initial cross-sectional survey, conducted beginning in 2016, and is intended to update results from earlier national epidemiologic surveys of people with migraine in the United States. Methods: Respondents to the MAST Study were recruited from a US nationwide online research panel. Stratified random sampling identified a representative cohort of adults (aged ≥18 years). We administered a validated diagnostic screener based on modified ICHD-3 beta criteria to identify individuals with migraine averaging at least 1 monthly headache day (MHD) over the previous 3 months. A baseline assessment evaluated sociodemographic and headache features, patterns of consultation and diagnosis, and use of acute and preventive medications for migraine. Frequency data and chi-square contrasts (P <.05) were used to compare respondents based on gender. Results: Baseline survey data (N = 95,821) identified 18,353 respondents who met criteria for migraine, including 15,133 (women n = 11,049, men n = 4084) reporting at least 1 MHD for the preceding 3 months. The mean age of the sample was 43.1 (13.6) years; 73.0{\%} of respondents were women, and 81.0{\%} were Caucasian. Compared with men, women were younger (46.1 vs 42.0 years; P <.001); had more MHDs (5.6 vs 5.3; P <.001); and were more likely to report moderate or severe headache-related disability (45.9{\%} vs 35.8{\%}; P <.001) and cutaneous allodynia (43.7{\%} vs 29.5{\%}; P <.001). The lifetime rate of medical consultation for headache was 79.8{\%} overall and slightly higher in women than in men. Women were more likely than men to have been diagnosed with migraine (48.3{\%} vs 38.8{\%}, P <.001). While 95.1{\%} of people with migraine currently used acute treatment, the majority (58.9{\%}) used over-the-counter (OTC) drugs to the exclusion of prescription drugs, while 11.3{\%} used exclusively prescription drugs, and 20.5{\%} used both. Among acute prescription medication users, women were more likely than men to take triptans (17.7{\%} vs 14.3{\%}, P <.001), while men were more likely than women to take opioids (14.5{\%} vs 9.2{\%}, P <.001). Oral formulations were used predominately (92.7{\%} of the medication users), but men were more likely to use nasal sprays (13.6{\%} vs 9.4{\%}, P <.001) and injectables (7.9{\%} vs 3.4{\%}, P <.001). Men (14.5{\%}) were also significantly more likely than women (10.4{\%}) to be taking daily oral preventive medication (P <.001). Conclusions: The MAST Study identified a large sample of women and men with migraine from a sampling frame that broadly resembles the US population. Low participation rate increases the risk of response bias, however, comparisons with Census data and prior population studies for the demographic and headache characteristics of the current sample suggest that findings are generalizable to the population of people with migraine. Women had more MHDs than men, and they were more likely to report migraine-related disability and cutaneous allodynia. The lifetime consultation rate for headache was relatively high, but many with migraine symptoms reported never having received a diagnosis of migraine from a healthcare professional. Acute prescription and preventive migraine treatments are underused. Migraine persists as an underdiagnosed and undertreated public health problem in 2018, and there are many opportunities to improve the diagnosis and treatment of people with this painful, disabling condition.",
keywords = "allodynia, epidemiology, gender, migraine, treatment optimization, treatment patterns",
author = "Lipton, {Richard B.} and Sagar Munjal and Aftab Alam and Buse, {Dawn C.} and Fanning, {Kristina M.} and Reed, {Michael L.} and Schwedt, {Todd J.} and Dodick, {David W.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1111/head.13407",
language = "English (US)",
volume = "58",
pages = "1408--1426",
journal = "Headache",
issn = "0017-8748",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Migraine in America Symptoms and Treatment (MAST) Study

T2 - Baseline Study Methods, Treatment Patterns, and Gender Differences

AU - Lipton, Richard B.

AU - Munjal, Sagar

AU - Alam, Aftab

AU - Buse, Dawn C.

AU - Fanning, Kristina M.

AU - Reed, Michael L.

AU - Schwedt, Todd J.

AU - Dodick, David W.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objectives: To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. Background: The MAST Study is a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine. This analysis focuses on the initial cross-sectional survey, conducted beginning in 2016, and is intended to update results from earlier national epidemiologic surveys of people with migraine in the United States. Methods: Respondents to the MAST Study were recruited from a US nationwide online research panel. Stratified random sampling identified a representative cohort of adults (aged ≥18 years). We administered a validated diagnostic screener based on modified ICHD-3 beta criteria to identify individuals with migraine averaging at least 1 monthly headache day (MHD) over the previous 3 months. A baseline assessment evaluated sociodemographic and headache features, patterns of consultation and diagnosis, and use of acute and preventive medications for migraine. Frequency data and chi-square contrasts (P <.05) were used to compare respondents based on gender. Results: Baseline survey data (N = 95,821) identified 18,353 respondents who met criteria for migraine, including 15,133 (women n = 11,049, men n = 4084) reporting at least 1 MHD for the preceding 3 months. The mean age of the sample was 43.1 (13.6) years; 73.0% of respondents were women, and 81.0% were Caucasian. Compared with men, women were younger (46.1 vs 42.0 years; P <.001); had more MHDs (5.6 vs 5.3; P <.001); and were more likely to report moderate or severe headache-related disability (45.9% vs 35.8%; P <.001) and cutaneous allodynia (43.7% vs 29.5%; P <.001). The lifetime rate of medical consultation for headache was 79.8% overall and slightly higher in women than in men. Women were more likely than men to have been diagnosed with migraine (48.3% vs 38.8%, P <.001). While 95.1% of people with migraine currently used acute treatment, the majority (58.9%) used over-the-counter (OTC) drugs to the exclusion of prescription drugs, while 11.3% used exclusively prescription drugs, and 20.5% used both. Among acute prescription medication users, women were more likely than men to take triptans (17.7% vs 14.3%, P <.001), while men were more likely than women to take opioids (14.5% vs 9.2%, P <.001). Oral formulations were used predominately (92.7% of the medication users), but men were more likely to use nasal sprays (13.6% vs 9.4%, P <.001) and injectables (7.9% vs 3.4%, P <.001). Men (14.5%) were also significantly more likely than women (10.4%) to be taking daily oral preventive medication (P <.001). Conclusions: The MAST Study identified a large sample of women and men with migraine from a sampling frame that broadly resembles the US population. Low participation rate increases the risk of response bias, however, comparisons with Census data and prior population studies for the demographic and headache characteristics of the current sample suggest that findings are generalizable to the population of people with migraine. Women had more MHDs than men, and they were more likely to report migraine-related disability and cutaneous allodynia. The lifetime consultation rate for headache was relatively high, but many with migraine symptoms reported never having received a diagnosis of migraine from a healthcare professional. Acute prescription and preventive migraine treatments are underused. Migraine persists as an underdiagnosed and undertreated public health problem in 2018, and there are many opportunities to improve the diagnosis and treatment of people with this painful, disabling condition.

AB - Objectives: To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. Background: The MAST Study is a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine. This analysis focuses on the initial cross-sectional survey, conducted beginning in 2016, and is intended to update results from earlier national epidemiologic surveys of people with migraine in the United States. Methods: Respondents to the MAST Study were recruited from a US nationwide online research panel. Stratified random sampling identified a representative cohort of adults (aged ≥18 years). We administered a validated diagnostic screener based on modified ICHD-3 beta criteria to identify individuals with migraine averaging at least 1 monthly headache day (MHD) over the previous 3 months. A baseline assessment evaluated sociodemographic and headache features, patterns of consultation and diagnosis, and use of acute and preventive medications for migraine. Frequency data and chi-square contrasts (P <.05) were used to compare respondents based on gender. Results: Baseline survey data (N = 95,821) identified 18,353 respondents who met criteria for migraine, including 15,133 (women n = 11,049, men n = 4084) reporting at least 1 MHD for the preceding 3 months. The mean age of the sample was 43.1 (13.6) years; 73.0% of respondents were women, and 81.0% were Caucasian. Compared with men, women were younger (46.1 vs 42.0 years; P <.001); had more MHDs (5.6 vs 5.3; P <.001); and were more likely to report moderate or severe headache-related disability (45.9% vs 35.8%; P <.001) and cutaneous allodynia (43.7% vs 29.5%; P <.001). The lifetime rate of medical consultation for headache was 79.8% overall and slightly higher in women than in men. Women were more likely than men to have been diagnosed with migraine (48.3% vs 38.8%, P <.001). While 95.1% of people with migraine currently used acute treatment, the majority (58.9%) used over-the-counter (OTC) drugs to the exclusion of prescription drugs, while 11.3% used exclusively prescription drugs, and 20.5% used both. Among acute prescription medication users, women were more likely than men to take triptans (17.7% vs 14.3%, P <.001), while men were more likely than women to take opioids (14.5% vs 9.2%, P <.001). Oral formulations were used predominately (92.7% of the medication users), but men were more likely to use nasal sprays (13.6% vs 9.4%, P <.001) and injectables (7.9% vs 3.4%, P <.001). Men (14.5%) were also significantly more likely than women (10.4%) to be taking daily oral preventive medication (P <.001). Conclusions: The MAST Study identified a large sample of women and men with migraine from a sampling frame that broadly resembles the US population. Low participation rate increases the risk of response bias, however, comparisons with Census data and prior population studies for the demographic and headache characteristics of the current sample suggest that findings are generalizable to the population of people with migraine. Women had more MHDs than men, and they were more likely to report migraine-related disability and cutaneous allodynia. The lifetime consultation rate for headache was relatively high, but many with migraine symptoms reported never having received a diagnosis of migraine from a healthcare professional. Acute prescription and preventive migraine treatments are underused. Migraine persists as an underdiagnosed and undertreated public health problem in 2018, and there are many opportunities to improve the diagnosis and treatment of people with this painful, disabling condition.

KW - allodynia

KW - epidemiology

KW - gender

KW - migraine

KW - treatment optimization

KW - treatment patterns

UR - http://www.scopus.com/inward/record.url?scp=85055258794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055258794&partnerID=8YFLogxK

U2 - 10.1111/head.13407

DO - 10.1111/head.13407

M3 - Article

VL - 58

SP - 1408

EP - 1426

JO - Headache

JF - Headache

SN - 0017-8748

IS - 9

ER -