OBJECTIVES: Activated patients are those who have the motivation, knowledge, skills, and confidence to make effective decisions to manage their health. The objective of this study was to compare patient characteristics and economic outcomes of patients with episodic migraine (EM) and chronic migraine (CM) by level of patient activation.

METHODS: Data were included from the 2017 US National Health and Wellness Survey (NHWS), a self-administered, nationally representative, Internet-based questionnaire of US adults. Patients with self-reported physician diagnosis of migraine were included in this analysis. Subgroups included patients with EM (0-14 headache days), and CM (≥15 headache days) in the past 30 days. Respondents were grouped into four levels of activation based on the Patient Activation Measure (PAM), from low (1) to high (4). Data collected included patient characteristics, health-related quality of life (EQ5D-5L) and resource utilization. Descriptive and bivariate analyses examined the differences between PAM groups.

RESULTS: Overall, 6,094 migraine patients were included (87% EM; 13% CM). 76.6% of patients had higher levels of activation (levels 3 and 4). Most patients were females (74.1%, level 1; 77.2%, level 4). Patients with higher levels of activation were more likely to be older, have higher income levels, and have private insurance, and were less likely to be obese. Patients in PAM level 1 had significantly more healthcare provider visits (means, 7.07 vs. 6.57 vs. 5.95 vs. 5.57, p=0.003), higher rates of absenteeism (means, 16.38 vs. 10.94 vs. 8.79 vs. 9.35, p<0.001), higher total indirect costs (means, $14,789.07 vs. $11,779.32 vs. $10,501.34 vs $10,134.82, p<0.001) and lower EQ5D-5L Index score (means, 0.65 vs. 0.71 vs. 0.76 vs. 0.78, p<0.001) than those with higher PAM levels. These findings appear to be driven largely by EM versus CM patients.

CONCLUSIONS: Increasing activation level in patients with migraine was associated with better health and economic outcomes, particularly in EM patients.