Dallas, Texas; Durham, N.C.; and Cleveland, Ohio From the Departments of Plastic Surgery of University of Texas Southwestern Medical Center, Duke University, and Case Western Reserve University.
Plast Reconstr Surg. 2012 Apr;129(4):871-877. doi: 10.1097/PRS.0b013e318244217a.
This study is meant to compare the direct and indirect cost of migraine headache care before and after migraine surgery and to evaluate any postoperative changes in patient participation in daily activities.
Eighty-nine patients enrolled in a migraine surgery clinical trial completed the Migraine-Specific Quality-of-Life Questionnaire, the Migraine Disability Assessment questionnaire, and a financial cost report preoperatively and 5 years postoperatively.
Mean follow-up was 63.0 months (range, 56.9 to 72.6 months). Migraine medication expenses were reduced by a median of $1997.26 annually. Median cost reduction for alternative treatment expenses was $450 annually. Patients had a median of three fewer annual primary care visits for the migraine headache treatment, resulting in a median cost reduction of $320 annually. Patients missed a median of 8.5 fewer days of work or childcare annually postoperatively, with a median regained income of $1525. The median total cost spent on migraine headache treatment was $5820 per year preoperatively, declining to $900 per year postoperatively. Total median cost reduction was $3949.70 per year postoperatively. The mean surgical cost was $8378. Significant improvements were demonstrated in all aspects of the Migraine-Specific Quality-of-Life Questionnaire and the Migraine Disability Assessment questionnaire.
Surgical deactivation of migraine trigger sites has proven to be effective for the treatment of severe migraine headache. This study illustrates that the surgical treatment is a cost-effective modality, reducing direct and indirect costs. Patients may also expect improvements in the performance of and increased participation in activities of daily living.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
本研究旨在比较偏头痛手术前后直接和间接医疗成本，并评估患者术后参与日常活动的任何变化。
89 名参与偏头痛手术临床试验的患者在术前和术后 5 年完成了偏头痛特异性生活质量问卷、偏头痛残疾评估问卷和财务费用报告。
平均随访时间为 63.0 个月（范围为 56.9 至 72.6 个月）。偏头痛药物治疗费用每年减少 1997.26 美元。替代治疗费用的中位数每年减少 450 美元。患者每年偏头痛治疗的初级保健就诊次数中位数减少了 3 次，每年节省 320 美元。术后，患者每年平均减少 8.5 天的工作或儿童保育缺勤，平均恢复收入 1525 美元。术前偏头痛治疗每年的总花费中位数为 5820 美元，术后降至每年 900 美元。术后每年的总中位数成本降低了 3949.70 美元。手术的平均费用为 8378 美元。所有方面的偏头痛特异性生活质量问卷和偏头痛残疾评估问卷都显示出显著的改善。
偏头痛触发点的手术失活已被证明对严重偏头痛头痛的治疗有效。本研究表明，手术治疗是一种具有成本效益的治疗方法，可以降低直接和间接成本。患者还可能期望日常生活活动的表现得到改善，并增加参与度。
临床问题/证据水平：治疗，IV。
