The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data

Abstract Background Migraine accounts for more disability than all other neurologic conditions combined. Despite this, more than 40% of people with migraine do not seek medical care. Migraine is associated with a higher risk of comorbidities, adding to the symptom burden. Currently, there is limited...

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Main Authors: Nicole Limberg, Jason C. Ray, Benjamin Harvey, Giles Stratton, Angus Cuskelly, Charmaine S. Tam, David Witcombe
Format: Article
Language:English
Published: BMC 2025-08-01
Series:The Journal of Headache and Pain
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Online Access:https://doi.org/10.1186/s10194-025-02103-2
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author Nicole Limberg
Jason C. Ray
Benjamin Harvey
Giles Stratton
Angus Cuskelly
Charmaine S. Tam
David Witcombe
author_facet Nicole Limberg
Jason C. Ray
Benjamin Harvey
Giles Stratton
Angus Cuskelly
Charmaine S. Tam
David Witcombe
author_sort Nicole Limberg
collection DOAJ
description Abstract Background Migraine accounts for more disability than all other neurologic conditions combined. Despite this, more than 40% of people with migraine do not seek medical care. Migraine is associated with a higher risk of comorbidities, adding to the symptom burden. Currently, there is limited epidemiological data available on the prevalence and incidence of migraine in the Australian primary care setting. This study aimed to describe the epidemiology (prevalence and incidence) of diagnosed migraine within the Australian general practice population. Methods Electronic health record data captured by national clinical practice management software over a 14-year index period (2010–2024) was analysed. The point prevalence of diagnosed migraine was estimated. The incidence of diagnosed migraine was estimated based on patients with new onset migraine during the index period. Estimates were stratified by age and sex. Differences by sociodemographic groups, patterns of treatment, and referral pathways were also evaluated. Results The study encompassed a total of 37,579 eligible migraine prevalent cases. The overall adjusted point prevalence of diagnosed migraine was estimated as 7.02 per 1,000 persons (95% confidence interval (CI) 6.79 to 7.25), which equates to 0.702% after adjusting for the interaction of age and sex. The overall incidence rate (IR) was estimated as 3.48 per 1,000 person-years (95% CI 3.38 to 3.58) after adjusting for the interaction of age and sex. Depression and anxiety were reported four times more frequently in the migraine population. High use of opioids and opioid combinations (54.75%) was noted in the migraine population, as well as a lower-than-expected use of triptans (51.06%). Among those with migraine, 32.03% had been referred to a physiotherapist and 18.64% had been referred to a neurologist. Conclusions This is the first study to describe the IR, accounting for life-years, in the Australian general practice population. The point prevalence of diagnosed migraine and incidence were lower than population-based estimates from other regions. The findings indicate that migraines are frequently underdiagnosed in the Australian primary care setting, with a possible lack of awareness of potential presentations for migraine, including neck pain, and highlight the need for further patient and clinician education.
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spelling doaj-art-2441a284e1014974bf4e594131f2c0192025-08-24T11:41:15ZengBMCThe Journal of Headache and Pain1129-23772025-08-0126111310.1186/s10194-025-02103-2The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record dataNicole Limberg0Jason C. Ray1Benjamin Harvey2Giles Stratton3Angus Cuskelly4Charmaine S. Tam5David Witcombe6Migraine SpecialistThe Alfred Hospital, Austin Health and Monash UniversityPfizer Australia Pty LtdPfizer Australia Pty LtdMedicalDirector (Telstra Health)MedicalDirector (Telstra Health)Pfizer Australia Pty LtdAbstract Background Migraine accounts for more disability than all other neurologic conditions combined. Despite this, more than 40% of people with migraine do not seek medical care. Migraine is associated with a higher risk of comorbidities, adding to the symptom burden. Currently, there is limited epidemiological data available on the prevalence and incidence of migraine in the Australian primary care setting. This study aimed to describe the epidemiology (prevalence and incidence) of diagnosed migraine within the Australian general practice population. Methods Electronic health record data captured by national clinical practice management software over a 14-year index period (2010–2024) was analysed. The point prevalence of diagnosed migraine was estimated. The incidence of diagnosed migraine was estimated based on patients with new onset migraine during the index period. Estimates were stratified by age and sex. Differences by sociodemographic groups, patterns of treatment, and referral pathways were also evaluated. Results The study encompassed a total of 37,579 eligible migraine prevalent cases. The overall adjusted point prevalence of diagnosed migraine was estimated as 7.02 per 1,000 persons (95% confidence interval (CI) 6.79 to 7.25), which equates to 0.702% after adjusting for the interaction of age and sex. The overall incidence rate (IR) was estimated as 3.48 per 1,000 person-years (95% CI 3.38 to 3.58) after adjusting for the interaction of age and sex. Depression and anxiety were reported four times more frequently in the migraine population. High use of opioids and opioid combinations (54.75%) was noted in the migraine population, as well as a lower-than-expected use of triptans (51.06%). Among those with migraine, 32.03% had been referred to a physiotherapist and 18.64% had been referred to a neurologist. Conclusions This is the first study to describe the IR, accounting for life-years, in the Australian general practice population. The point prevalence of diagnosed migraine and incidence were lower than population-based estimates from other regions. The findings indicate that migraines are frequently underdiagnosed in the Australian primary care setting, with a possible lack of awareness of potential presentations for migraine, including neck pain, and highlight the need for further patient and clinician education.https://doi.org/10.1186/s10194-025-02103-2Migraine disordersEpidemiologyPrimary health careAustraliaSerotonin 5-HT1 receptor agonistsAnalgesic agents
spellingShingle Nicole Limberg
Jason C. Ray
Benjamin Harvey
Giles Stratton
Angus Cuskelly
Charmaine S. Tam
David Witcombe
The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
The Journal of Headache and Pain
Migraine disorders
Epidemiology
Primary health care
Australia
Serotonin 5-HT1 receptor agonists
Analgesic agents
title The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
title_full The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
title_fullStr The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
title_full_unstemmed The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
title_short The epidemiology, management, and the associated burden of migraine in Australian primary care: a retrospective analysis of electronic health record data
title_sort epidemiology management and the associated burden of migraine in australian primary care a retrospective analysis of electronic health record data
topic Migraine disorders
Epidemiology
Primary health care
Australia
Serotonin 5-HT1 receptor agonists
Analgesic agents
url https://doi.org/10.1186/s10194-025-02103-2
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