Characteristics of migraine in patients with headache disorders: A clinic-based study from Central American and Caribbean countries.

OBJECTIVE: The objective of the study was to measure the proportion of patients who consulted for headache and of those who had a final diagnosis of migraine. We also assessed the proportion and characteristics of patients with migraine and the impact of migraine on the daily activities and the professional and social lives of patients visiting private/public medical centers in Guatemala, Costa Rica, Panama, and the Dominican Republic. BACKGROUND: Underdiagnosis of migraine is high in Central America and Caribbean urban communities. However, there is limited knowledge on characteristics of headache disorders for the appropriate classification of migraine, which is a prerequisite for targeted treatment. Hence, there is a need to improve migraine awareness among patients and medical professionals in this region. METHODS: Central America and Caribbean countries epidemioLogy study of Migraine (CALM) was a non-interventional, cross-sectional, multinational study in adults aged 18-65 years with a history of or current headache. The primary outcome was the proportion of patients with migraine visiting medical centers due to headache disorders. Using a specially designed migraine survey questionnaire, patients self-reported migraine characteristics, duration, and severity of attacks and impact on work and social life. RESULTS: Of the 313 enrolled patients, 308 (98.4%) completed the study. Approximately 75.3% (232/308) of patients with headache visiting medical centers had migraine, with episodic migraine being the most common (193 [83.2%]). Overall, 34/308 (11.0%) patients had a new diagnosis of migraine. Among patients with migraine, 66 (28.4%) had a history of migraine for ≥20 years and 59 (25.4%) experienced severe pain. Overall, 52.2% (121/232) of patients reported that migraine affected their professional life and 78.4% (182/232) reported an impact on social life. CONCLUSION: The CALM study establishes that a high proportion of patients with migraine had a long duration and high severity of migraine attacks, leading to a direct impact on work/social life as well as on costs incurred by patients in these countries.

Costs of multiple sclerosis in Panama from societal, patient perspectives and health-related quality of life.

The purpose of this work is to estimate the costs associated with managing patients with MS in Panama and evaluating the impact of the disease on their health-related quality of life (HRQoL). Multicentric observational, retrospective, cross-sectional study. The costs were estimated from societal and patient perspectives and expressed in USD, 2015. The focus of the study is based on prevalence and on a "bottom-up" approach. To estimate the total cost per patient, annual reported use for each resource was multiplied by its unit cost. To evaluate HRQoL, patients completed the EQ-5D-3L questionnaire. 108 patients took part in the study. 82.41% were women with 44.78 (SD: 12.27) years. 61.11% presented mild (EDSS = 0-3.5), 25.93% moderate (EDSS = 3.5-6) and 12.96%, severe disability (EDSS≥6.5). The mean annual cost from the patient's perspective was estimated at 777.99 USD (SD: 1,741.45) per patient. The mean cost from a societal perspective was estimated at 23,803.21 USD (SD: 13,331.83) per patient. Disease-modifying therapies (DMT) accounted for the main component of the cost. A deterioration in HRQoL was observed as the disease advances and as disability increases, with mobility and usual activities being the areas most affected by its progression. From both perspective, the cost per MS patient in Panama is high. In addition to the high economic impact, MS also exerts a negative impact on patient HRQoL, which increases as the disease advances.

Prevalencia de enfermedades neurologica en el corregimiento de Belisario Porras, Distrito di San Miguelito, en Panama, 1986

Utilizando el Protocolo para estudios Neuro-epidemiológicos de la Organización Mundial de la Salud (OMS) se realizó un análisis piloto para determinar la prevalencia de las principales Enfermedades Neurológicas que incluían Migraña, Epilepsia, Enfermedad Extrapiramidal, Neuropatía Periférica, Enfermedad Cerebro Vascular, y Retardo Mental, en el Corregimiento Belisario Porras del Distrito Especial de San Miguelito, en la ciudad de Panamá. La investigación se hizo en una muestra seleccionada estadísticamente y que era representativa del Corregimiento Belisario Porras. De los 955 habitantes entrevistados, se hallaron sospechosos de Enfermedades Neurológicas 362 (37.9%) personas y 192 (20.1%) con Enfermedad Neurológica definitiva, en la siguiente prevalencia por 1,000 habitantes: Migraña 162.7, Epilepsia 22.5, Neuropatía Periférica 21.4, Retardo Mental 9.6, Enfermedad Cerebro Vascular 7.5 y Enfermedad Extrapiramidal 4.3. Estos resultados demuestran la alta pevalencia de las enfermedades neurológicas en nuestra población, la cual es confirmada con estudios similares efectuados en Ecuador, Colombia, Venezuela, Perú, Bolivia y Nigeria. Es la primera investigación de Prevalencia de Enfermedades neurológicas realizada en Panamá; y debe ser confirmada mediante estudios que empleen un protocolo similar en poblaciones mayores y por casos-control, para identificar factores de riesgo