Martin B C, Dorfman J H, McMillan J A, McMillan C A
Department of Pharmacy Care Administration, University of Georgia, Athens.
Clin Ther. 1994 Sep-Oct;16(5):855-72; discussion 854.
The estimates of migraine headache prevalence vary widely and fluctuate with the population examined and the methodologic factors used in studies examining this condition. As an alternative to survey techniques, a retrospective review of Medicaid claims data from 22 continuous months (January 1, 1989, to October 31, 1990) was used to detect medical episodes and physician-initiated pharmacologic therapy indicative of migraine headache. Specifically, the objectives of this study were to measure the prevalence of migraine headache in Georgia Medicaid recipients, estimate the prevalence in the US population, and describe the relationships between migraine and sociodemographic variables including sex, age, race, and rural versus urban residence. Logistic regression was used to isolate the independent effects of age, race, residence, and length of Medicaid eligibility on the presence or absence of migraine. The data consisted of adjudicated claims for 847,453 Georgia Medicaid recipients. Medicaid profiles for 678,079 recipients (468,448 female and 209,631 male) aged older than 4 years were analyzed as persons at risk of migraine. Migraine was identified in 6518 (1.39%) females and 991 (0.47%) males. Adjusting for eligibility, age, and race, the projected 22-month period prevalence for the United States was estimated as 3.83% (females) and 1.33% (males). Females, whites, and individuals residing in rural counties were more likely to suffer from migraine headache than their respective comparison groups. For both sexes, the peak prevalence was in the fourth and fifth decades of life. Migraine headache in the United States is estimated to afflict 4.5 million females and 1.4 million males. This prevalence is lower than previously reported and indicates that migraine headache may not be as common as previously believed. An alternative explanation is that many Medicaid recipients self-treat the condition, thus circumventing physician care and subsequent diagnosis and treatment.
偏头痛患病率的估计值差异很大，并且会随着所研究的人群以及研究该疾病时所采用的方法学因素而波动。作为调查技术的替代方法，一项对22个连续月（1989年1月1日至1990年10月31日）医疗补助索赔数据的回顾性分析被用于检测表明偏头痛的医疗事件和医生发起的药物治疗情况。具体而言，本研究的目的是测量佐治亚州医疗补助接受者中偏头痛的患病率，估计美国人群中的患病率，并描述偏头痛与社会人口统计学变量（包括性别、年龄、种族以及农村与城市居住情况）之间的关系。采用逻辑回归来分离年龄、种族、居住情况和医疗补助资格时长对偏头痛存在与否的独立影响。数据包括847,453名佐治亚州医疗补助接受者的已裁决索赔。对678,079名年龄超过4岁的接受者（468,448名女性和209,631名男性）的医疗补助档案进行分析，将其视为有偏头痛风险的人群。在女性中识别出6518例（1.39%）偏头痛，在男性中识别出991例（0.47%）。在调整了资格、年龄和种族因素后，估计美国22个月期间的患病率为女性3.83%，男性1.33%。女性、白人以及居住在农村县的个体比各自的对照组更易患偏头痛。对于两性而言，患病率高峰都出现在生命的第四个和第五个十年。据估计，美国有450万女性和140万男性患有偏头痛。这一患病率低于先前报道的水平，表明偏头痛可能不像先前认为的那么常见。另一种解释是，许多医疗补助接受者自行治疗该疾病从而规避了医生的诊治以及后续的诊断和治疗。
