Multimorbidity across multiple ICD-10 codes should be considered when treating migraine patients

In migraine, co-occurrence of two or more diseases or conditions is typical. Asthma and allergies, psychiatric, cardiovascular, cerebrovascular, gastrointestinal, musculoskeletal disorders, as well as other neurological and pain-related disorders are examples of common migraine-associated comorbidities.

A new real-wold evidence study, a collaborative effort between Medaffcon, Novartis and Terveystalo, on multimorbidity in migraine was published in The Journal of Headache and Pain. The study showed that the mean number of diagnoses per patient was increased 1.7-fold in migraine compared to controls. The median number of diagnoses was 12 and 6 in migraine patients and controls.

Multimorbidity was further studied using phenotypic disease networks. Here, a larger number of diagnoses with denser connections with each other were detected for migraine patients compared to controls. The biggest cluster in the migraine patients’ network was formed by functional-disorder-like symptoms including fatigue, respiratory, sympathetic nervous system, gastrointestinal, infection, mental and mood disorder diagnoses. As functional disorders have unknown causes but similar symptomology, it may be of interest to examine more underlying migraine in functional disorders or understand better the generalized symptoms apparently related to migraine.

“Instead of treating one symptom or disease at a time, multimorbidity should be considered when treating the migraine patients”, says Mariann Lassenius who is leading the RWE team at Medaffcon.

A previous study performed by Medaffcon showed a substantial increase in healthcare visits and sick leaves for migraine patients compared to controls. The current study further shows that this increase cannot be referred to a few driving morbidities but is associated with a generalized increase in multimorbidity across the whole ICD-10 coded spectrum.

This retrospective register study was performed using the electronic medical records obtained from the private healthcare provider Terveystalo. Of the consented occupational healthcare patients 17,623 had migraine according to the ICD-10 code. A one-to-one, age- and gender-matched control population without migraine was created. Controls were used as reference for comorbidity estimations.