Ayzenberg I, Katsarava Z, Sborowski A, Chernysh M, Osipova V, Tabeeva G, Steiner T J
Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany.
Eur J Neurol. 2014 May;21(5):758-65. doi: 10.1111/ene.12380. Epub 2014 Feb 13.
The study evaluated headache-attributed burden and its impact on productivity and quality of life (QoL) in Russia. Its purpose was to support recommendations for change.
A countrywide population-based random sample of 2725 biologically unrelated adults (aged 18-65 years) in 35 cities and nine rural areas of Russia were interviewed in a door-to-door survey. The structured questionnaire enquired into symptom burden, functional disability, lost productive time and QoL (applying the WHOQoL-8 question set), as well as willingness to pay (WTP) for adequate headache treatment, if it were available.
Mean lost paid-work days due to headache in the previous 3 months were 1.9 ± 4.2, and mean lost household work days were 3.4 ± 5.7. The estimated annual indirect cost of primary headache disorders was USD 22.8 billion, accounting for 1.75% of gross domestic product. QoL was reduced by all types of primary headaches. According to WHOQoL-8, it was significantly lower in those with headache on ≥15 days/month than in those with episodic headache (24.7 ± 4.6 vs. 28.1 ± 5.0; P < 0.05) and lower in those with migraine than in those with tension-type headache (TTH) (27.1 ± 4.9 vs. 28.8 ± 5.0; P < 0.05). Average WTP for adequate headache treatment was RUB 455 ± 494 per month (median RUB 300), a sum sufficient in most cases, and correlated with illness severity (higher for headache on ≥15 days/month than for migraine, and for migraine than for TTH).
Headache is common, burdensome and costly in Russia and, manifestly, poorly mitigated by existing healthcare. Structured healthcare services for headache need to be urgently put in place.
本研究评估了俄罗斯头痛所致负担及其对生产力和生活质量（QoL）的影响。其目的是为变革建议提供支持。
在俄罗斯35个城市和9个农村地区，对2725名无生物学亲缘关系的成年人（年龄在18 - 65岁之间）进行了基于全国人口的随机抽样，并进行了挨家挨户的调查。结构化问卷询问了症状负担、功能残疾、生产时间损失和生活质量（应用WHOQoL - 8问题集），以及如果有适当的头痛治疗，愿意支付的费用（WTP）。
在过去3个月中，因头痛导致的平均带薪工作日损失为1.9±4.2天，平均家务工作日损失为3.4±5.7天。原发性头痛疾病的估计年度间接成本为228亿美元，占国内生产总值的1.75%。所有类型的原发性头痛都会降低生活质量。根据WHOQoL - 8，每月头痛≥15天的患者的生活质量显著低于发作性头痛患者（24.7±4.6 vs. 28.1±5.0；P<0.05），偏头痛患者的生活质量低于紧张型头痛（TTH）患者（27.1±4.9 vs. 28.8±5.0；P<0.05）。适当头痛治疗的平均每月WTP为455±494卢布（中位数为300卢布），在大多数情况下这笔钱足够，且与疾病严重程度相关（每月头痛≥15天的患者高于偏头痛患者，偏头痛患者高于TTH患者）。
在俄罗斯，头痛很常见、负担重且成本高，显然现有医疗保健对此缓解不力。迫切需要建立针对头痛的结构化医疗服务。
