Changes in Migraine-Related Outcomes and Functioning at 1 Year: Results of the Longitudinal OVERCOME (US) Study

INTRODUCTION: Migraine is a common neurological disorder that can severely diminish quality of life. Quantifying migraine-related changes in a real-world population over time can increase understanding of the natural history of migraine and improve clinical care of individuals with migraine. METHODS: The Observational survey of the Epidemiology, treatment, and Care Of MigrainE (OVERCOME) is a web-based study that longitudinally assessed migraine-related outcomes in a demographically representative adult population with migraine in the United States. Migraine disease status was classified as "overall improved," "overall worsened," or "no net change" based on changes in monthly headache days (MHDs), the Migraine Disability Assessment Scale (MIDAS) score, and the Migraine-Specific Quality-of-Life Questionnaire-Role Function-Restrictive (MSQ-RFR) domain score over 1 year. Migraine-related characteristics and patient-reported outcomes were evaluated for each group. RESULTS: Among 11,634 individuals with migraine who completed the baseline and 1-year follow-up surveys, 40.4% were classified as having "overall improved," 24.1% as having "overall worsened," and 35.5% as having "no net change" migraine status at 1 year. The "overall improved" group reported decreases in MHDs [mean change from baseline (SD), -3.2 (5.0)] and MIDAS score [-15.4 (26.2)] and improvements in MSQ-RFR score [+ 13.7 (21.6)]. Additionally, the impact of migraine on work decreased, there was less stigma, and this group was less likely to overuse acute medications. The "overall worsened" group experienced more MHDs [+ 3.4 (5.7)], increased MIDAS score [+ 18.8 (29.0)], and worsening MSQ-RFR score [-14.1 (21.1)]. Migraine had a greater negative impact on their working lives, and they had a greater need for acute and preventive medications for migraine. CONCLUSION: MHD, MIDAS score, and MSQ-RFR score together provide a robust characterization of overall change in migraine over time. This study demonstrates the profound effect of improvement or worsening of migraine symptoms on workplace productivity, migraine-related stigma, physical function, and need for treatment.