Krishnan Anand, Chowdhury Debashish, Duggal Ashish, Amarchand Ritvik, Husøy Andreas, Steiner Timothy J
All India Institute of Medical Sciences, New Delhi, India.
GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
J Headache Pain. 2025 May 7;26(1):106. doi: 10.1186/s10194-025-02036-w.
We have previously shown headache to be highly prevalent in Delhi and National Capital Region of northern India, as we did earlier in Karnataka State in the south. Here we present a complementary study performed contemporaneously of headache-attributed burden, along with a population health-care needs assessment.
In a cross-sectional study using the standardised methodology of the Global Campaign against Headache, we randomly selected households, and one member aged 18-65 years from each, making unannounced visits. Trained interviewers used the HARDSHIP questionnaire incorporating enquiry into various aspects of headache-attributed burden: symptom burden, lost health, impaired participation in daily activities, quality of life (QoL) and willingness to pay (WTP) for treatment. Enquiry included questions about headache yesterday (HY).
Of N = 2,066, participants reporting headache in the past year spent 9.5% of their time with headache of moderate intensity (1.8 on the scale of 1-3). Population-level estimates of all time spent with headache were in the range 5.5-6.6%. On this measure, migraine (8.2%) was, at individual level, much more burdensome than tension-type headache (TTH) (1.7%), and females with migraine or TTH were more burdened (8.7% and 2.0% respectively) than males (6.0% and 1.0%). Migraine accounted for substantial health loss (3.6%) at individual level (disability weights from the Global Burden of Disease study factored in), but both measures of overall burden (QoL and WTP) found it greatest among those with probable medication-overuse headache (pMOH) or other causes of headache on ≥ 15 days/month (H15+), with TTH least. For all headache types, participation was more impaired in household than in paid work, the latter being little affected (overall, males 0.3 lost days/month, females 0.1). Impaired participation in social or leisure activities was close to unmeasurably low. Impaired participation from HY was 1.8% across all domains of activity. One quarter (26%) of the population aged 18-65 years would be expected to benefit from health care, meeting our criteria for need: 16.1% with migraine, 6.4% with H15+.
Headache disorders in northern India are not only prevalent but also associated with high burden. One quarter of the adult population would benefit from professional headache care.
我们之前已经表明，头痛在印度北部的德里及国家首都辖区极为普遍，正如我们之前在南部的卡纳塔克邦所发现的那样。在此，我们展示一项同期进行的关于头痛所致负担的补充研究，以及一项人群医疗保健需求评估。
在一项采用全球抗击头痛运动标准化方法的横断面研究中，我们随机选择家庭，并从每个家庭中随机选取一名年龄在18 - 65岁之间的成员，进行不事先通知的家访。经过培训的访谈者使用“艰难困苦”问卷，该问卷纳入了对头痛所致负担各个方面的询问：症状负担、健康损失、日常活动参与度受损、生活质量（QoL）以及治疗支付意愿（WTP）。询问内容包括关于昨天头痛（HY）的问题。
在N = 2066名参与者中，报告过去一年有头痛症状的参与者，其9.5%的时间处于中度头痛状态（在1 - 3级量表上为1.8级）。头痛所占用的总体时间在人群层面的估计范围为5.5% - 6.6%。就这一指标而言，在个体层面，偏头痛（8.2%）比紧张型头痛（TTH）（1.7%）的负担要大得多，患有偏头痛或TTH的女性负担更重（分别为8.7%和2.0%），高于男性（分别为6.0%和1.0%）。在个体层面（纳入了全球疾病负担研究中的残疾权重），偏头痛导致了相当大的健康损失（3.6%），但总体负担的两项指标（生活质量和支付意愿）均显示，在每月头痛≥15天的可能药物过量使用性头痛（pMOH）或其他头痛病因（H15 +）患者中负担最大，而紧张型头痛负担最小。对于所有头痛类型，在家庭活动中的参与度受损程度高于有偿工作，后者受影响较小（总体而言，男性每月损失0.3个工作日，女性每月损失0.1个工作日）。在社交或休闲活动中的参与度受损程度几乎低到无法测量。所有活动领域中，因昨天头痛导致的参与度受损为1.8%。预计18 - 65岁人群中有四分之一（26%）将从医疗保健中受益，符合我们的需求标准：偏头痛患者占16.1%，H15 +患者占6.4%。
印度北部的头痛疾病不仅普遍存在，而且负担沉重。四分之一的成年人口将从专业的头痛护理中受益。
