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Parkinson’s disease (PD) is a complex neurodegenerative condition that predominantly affects older people, with a rising prevalence worldwide.1,2 There are many on-going challenges and unmet needs in PD: difficulties in making an accurate diagnosis (particularly in the early stages of the disease), troubling side effects associated with the available pharmacological treatments, a lack of effective disease-modifying therapies […]

Highlights from the 17th Biennial Migraine Trust International Symposium 2018: Focus on Migraine – Value of Digital Data

Ray Ashton
Senior Medical Writer, Touch Medical Media, UK

Jon Shepheard
Neurology Account Director, Touch Medical Media, UK
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Published Online: Nov 6th 2018

Most patients want to access online information but are unsure about the reliability of sources. This is especially true for those with chronic disorders. Teva Pharmaceuticals have developed partnerships and initiatives to address this unmet need.1 In collaboration with Healint (developer of the Migraine Buddy platform), real-world evidence from migraine patients will be obtained about migraine in Europe. Patients opt in to share their experience anonymously and this information will be used to increase migraine awareness and for research, specifically to support the development of educational and supportive content for doctors, neurologists, healthcare professionals and those wishing to improve understanding of migraine. The Migraine Buddy platform is the world’s largest migraine tracking and research platform with over 1 million registered users and 100 million migraine days tracked.

Medical professionals increasingly use digital means for their medical education, exemplified by a 2017 Decision Resources Group report that found that millennial physicians rely more on digital information and source online medical journals and medical reference sites more frequently than older peers.2 The initiative involves collaboration between Teva Pharmaceuticals and the Migraine Trust International Symposium (MTIS) to develop online interviews with key opinion leaders including Peter J Goadsby. Initial research in 2018 found that in the UK:1

  • In total, 7 in 10 people (73%) have a chronic condition and 58% of UK respondents suffering from chronic conditions claim to have searched online resources for information on a weekly or monthly basis;
  • People living with chronic conditions were more likely to search for health information online on a weekly or monthly basis (58%) compared to those without chronic conditions (44%);
  • With respect to online health information, the biggest issue is understanding if it is trustworthy and reliable;
  • Search engines are the most popular online source of health information, but not the most trusted. For example, the NHS Choices website is the most trusted source of information in the UK with 75% of respondents stating they trust the site to have quality and dependable information.

MacGregor in collaboration with Curelator Inc. investigated repetitive yawning in patients with migraine.3 The Curelator N1-Headache digital platform, was used to track and analyse more than 70 factors associated with migraines.4 Repetitive yawning is a common premonitory symptom of migraine5,6 and has a higher predictive value than other premonitory symptoms including neck pain and tiredness.7 The aim of the study was to investigate the number of individuals recording excessive yawning and the statistical association between excessive yawning and migraine attacks. After 90 days, analysis using the univariate Cox proportional hazard model indicated that in 285 individuals, excessive yawning was associated with increased risk of migraine attack in 25.3% of participants (n=72, median hazard ratio=3, interquartile range [IQR]=4.0–2.2), with decreased risk and no significant within-person association in 1.4% (n=4) and 66.3% (n=189) respectively. When yawning was recorded in those with an increased risk, the occurrence of subsequent migraine was approximately three times the rate per unit time compared with when there was no yawning.3 These findings suggest that in some migraine sufferers excessive yawning is a sensitive predictor of migraine. Furthermore, early identification of migraine allows an opportunity for early intervention. One individual described repetitive yawning as a red flag to which she intervenes either through intake of fluids, sugar and caffeine or with medication, successfully reducing the number of monthly headache days from 6 to 4, on average.8

In summary, reliable information on migraines for both patients and healthcare professionals can be found on the MTIS online platform and is a useful addition to the numerous websites for migraine (https://www.migrainetrust.org/). Symptoms of migraine that could predict an attack could be invaluable to the sufferer and also provide data that can help to develop hypotheses for further investigation.

References

1.Business Wire press release. Teva Pharmaceuticals Europe: Patients Search for Information Online – but Aren’t Sure If They Can Trust What They Find. Available at: https://www.businesswire.com/news/home/20180905005871/en/Teva-Pharmaceuticals-Europe-Patients-Search-Information-Online (accessed 26 September 2018).
2.Decision Resources Group. Meet the Millennial Physicians – Young, Mobile, and Harder to Reach. DRG Digital. Available at: www.drgdigital.com/drg-digital-innovation-blog/meet-the-millennial-physicians-young-mobile-and-harder-to-reach (accessed 26 September 2018).
3.MacGregor EA, Donoghue S, Vives-Mestres M. Correlation of migraine attacks with excessive yawning. Presented at: Migraine Trust International Symposium 2018, 6–9 September 2018. Abstract MTIS2018-146.
4.N1-Headache. Available at: https://n1-headache.com/ (accessed 26 September 2018).
5.Laurell K, Artto V, Bendtsen L, et al. Premonitory symptoms in migraine: A cross-sectional study in 2714 persons. Cephalalgia. 2016;36:951–9.
6.Güven B, Güven H, Çomoğlu SS. Migraine and yawning. Headache. 2018;58:210–6.
7.Giffin NJ, Ruggiero L, Lipton RB, et al. Premonitory symptoms in migraine: and electronic diary study. Neurology. 2003;60:935–40.
8.CISION PR Web press release. Migraine Trust International Symposium (MTIS) 2018: New Curelator Data Affirms Repetitive Yawning as a Warning Symptom for Migraine Attacks. Available at: www.prweb.com/releases/migraine_trust_international_symposium_mtis_2018_new_curelator_data_affirms_repetitive_yawning_as_a_warning_symptom_for_migraine_attacks/prweb15721846.htm (accessed 26 September 2018).

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