FINAL_Migraine L&L Slides
Better data, better outcomes: Migraine
Presenter: Ernesto Ramirez, PhD
Director, Research Science
Agenda
● What are you currently missing?
● Migraine Experience Survey
○ Overview of survey
○ Insights into diagnosis and treatment
● MigraineSmart
● Use cases & questions
The richest data from individuals is mostly invisible to the health system
!
Data about health in everyday life provides a
more comprehensive view of:
● Disease progression
● Treatment impact
● Symptom frequency and burden
● Quality of life and activities of daily living
● Factors influencing outcomes including
behavior, attitude, and environment
Leading to
➔ More effective and inclusive research
➔ Identification of new biomarkers
➔ Enhanced evidence of treatment benefit
➔ Better informed clinical care guidelines
EVIDATION MIGRAINE EXPERIENCE SURVEY HIGHLIGHTS
Migraine Experience Survey Overview
Objective: Understand real-world experiences of migraine
including symptom frequency and severity, activity and
sleep, care experiences, and treatment initiation
!
Setting: Open to any member of the Evidation Community —the largest, most diverse virtual research cohort in the
U.S. with nearly 5 million people
Scale: 21,380 Evidation Members enrolled in the survey
Timing: Findings presented are from January to December
2023; survey ongoing
Privacy and trust: All participants explicitly opted in to
sharing their responses and historical activity and sleep
data in aggregate for this research program
Engaging a community of individuals with migraine over time
Over 21,000 Evidation Members engaged with the Migraine Experience Survey to better understand their
real-world experience with migraine, including symptom frequency and severity, medication use patterns,
and experience with healthcare providers.
Baseline*
N = 10,406
!
Month 3
N = 9,130
!
Month 6
N = 7,785
!
*January 2023 cohort
Month 9
N = 6,319
!
Passively collected wearable data where available
52,749 total surveys
covering OTC medication use/alternative
therapies, lifestyle changes, and symptom
frequency and severity in the past 3 months
Reports of 11,590 in-person HCP visits
and 2,735 telehealth HCP visits
4,652 prescription treatment changes
16,000+ have activity data connected to the platform
Underdiagnosis and undertreatment in migraine
Background
➜ One study suggests that only
about 5% of people with
chronic migraine are
correctly diagnosed and
prescribed recommended
1
medication
!
➜ Another demonstrated that
only 41% of individuals with
migraine eligible for
predictive treatment are
2
currently taking it
currently taking it
2
Why is this important?
➜ Underdiagnosis and
undertreatment contribute to
poorer quality of life and lost
productivity among people
with migraine
!
➜ However, additional research
is needed to understand
treatment non-initiation and
potential strategies to
address it
How can direct-to- participant data help?
➜ Our data showed that 41% of
individuals did not see any healthcare
provider for migraine in the past year
and thus would not be represented in
claims data or EMR data
➜ Detailed symptom diaries capturing
patterns of migraine symptom type,
frequency, and severity can be paired
with social determinants of health
data to better understand predictors
of treatment seeking
!
➜ Wearable data can be used to identify
subgroups who experience disability
due to migraine and are not currently
taking treatment
Symptom severity reports reveal individuals who may benefit from treatment
11,240 individuals reported at least 4 migraine days per month
and could be eligible for preventive treatment
Yet, 31% used only OTC medications to manage migraine. Of
these individuals 50-75% experienced severe throbbing and
sensitivity to light, sound, and/or smell
Within this 31%, exploratory analysis showed that individuals
only taking OTC medications were:
● 68% less likely to have a neurologist as their usual
provider compared to prescription users (more likely to
see a general practitioner instead)
● 41% more likely to be an adult under 44 yo than middle
age adults (45-59 yo)
● Twice as likely to not have health insurance
Wearable data can help identify subgroups with unmet needs
Although men and women self-report similar negative impacts of migraine on their sleep, men who rely solely
on OTC treatment sleep fewer minutes than those who take Rx medication, highlighting their unseen burden
!
Understanding unmet need in this
subgroup is important given men are more
likely to rely on OTC treatment instead of
prescription medication and are less likely
3
to report pain and seek care for migraine
!
!
Individuals cycle through treatments before finding a regimen that works for them
Background
➜ 50% of individuals do not
find Calcitonin Gene-Related
Peptide Receptor
medications to be effective in
4
managing migraine
!
➜ 2 to 3 months is estimated as
the average time before
people living with migraine
discontinue oral migraine
5
prevention medication
Why is this important?
➜ Early identification of
treatment non-response,
satisfaction, and potential for
premature discontinuation is
key for addressing migraine
burden
!
How can direct-to- participant data help?
➜ Daily symptom diaries can be
used to track migraine
outcomes while individuals
start a new medication class
and identify those who need
additional support
➜ Longitudinal data can reveal
average trends in medication
effectiveness in the real world,
where treatment adherence
and external factors less
strictly controlled
!
Longitudinal symptom reports illustrate trends in treatment response in real world settings
Individuals experienced increased migraine frequency prior to starting preventive medication with significant
reductions in the next 3 months
!
On average, there are
statistically significant
reductions in number of
headache days within 90
days of treatment initiation
Average number of
headache days remains
stable among those who
reported consistent use of
preventive medication.
Real world experience & support: MigraineSmart
Harnessing survey data, electronic participant reported outcomes
(ePROs), wearable data, and evidence-based content to help
individuals better understand and manage their migraines.
Daily monitoring: Simple daily migraine “1-click”
check-in
Follow-up surveys: Quick survey to capture severity,
symptoms, triggers, and medication use.
Feedback to participants: Get weekly insights and a
monthly report aligning symptom logs with wearable
data to see the relationship between symptoms and
daily activities.
!
MigraineSmart participants find the program valuable
Participants use the daily logging and the monthly reports to better understand their condition
and communicate with their care team.
“I use it to track the number of
days I’m having symptoms”
“I use to help understand
frequency and be more conscious”
“Has helped me overall better
understand my migraines as a
whole and more aware of non
head pain symptoms that occur
early”
These surveys and programs serve as a springboard for more detailed views of the patient journey and identifying individuals for further study
Patient Experience Datasets
➔ Integrate survey and wearable
data with claims or EHR to
better understand healthcare
utilization and build detailed
patient journeys, including the
patient experience in between
healthcare visits and potential
confounders in your analysis
!
Patient Insights
➔ Identify individuals
experiencing specific
constellations of symptoms
and explore cohort
specific challenges and
unmet need
!
➔ Identify individuals who
recently reported changes in
medication or symptom
progression to further study
drivers
Real-World Studies
➔ Define subgroups for
enrollment in clinical trials of
new digital therapeutics or
medication
➔ Launch prospective study with
higher frequency data
collection to better understand
day-to-day dynamics of
migraine
!
Questions
For additional information
email us at partner@evidation.com
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