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Workplace Productivity

A Review of the Impact of Migraine and its Treatment

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Abstract

Migraine is a common disorder characterised by recurrent episodes of disability. Despite the high prevalence of migraine, data have been lacking on its impact in a working population. The advent of new therapies has stimulated interest in this area, and evidence is now available that documents the substantial impact of migraine on workplace productivity and the likelihood of untreated migraine leading to unemployment or underemployment for the patient.

This paper reviews current findings of both observational and interventional studies about the impact of migraine on productivity and employment. When considered in the light of migraine demographics, the high prevalence of migraine, and its low consultation and treatment rates, this evidence indicates that improved screening and treatment for this common condition could have a substantial impact on worker productivity and on patient well-being.

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References

  1. Ettner S, Frank R, Kessler RC. The impact of psychiatric disease on labor market outcomes. Ind Labor Relat Rev 1997; 51: 64–81

    Article  Google Scholar 

  2. Conti DJ, Burton WN. The economic impact of depression in the workplace. J Occup Med 1994; 36: 983–8

    PubMed  CAS  Google Scholar 

  3. Greenberg PE, Kessler RC, Nells TL, et al. Depression in the workplace: an economic perspective. In: Feighner JP, Boyers WF, editors. Selective serotonin reuptake inhibitors: advances in basic research and clinical practice. 2nd ed. Chichester: Wiley, 1996: 321–58

    Google Scholar 

  4. Greenberg PE, Finklestein SN, Berndt ER. Economic consequences of illness in the workplace. Sloan Manage Rev 1995; 36: 26–38

    Google Scholar 

  5. Blau JN. Adult migraine: the patient observed. In: Blau JN, editor. Migraine: clinical and research aspects. Baltimore (MD): Johns Hopkins University Press, 1987: 3–17

    Google Scholar 

  6. Cady RK. Diagnosis and treatment of migraine. Clin Cornerstone 1999; 1 (6): 21–32

    Article  PubMed  CAS  Google Scholar 

  7. Luciani R, Carter D, Mannix L, et al. Prevention of migraine during prodrome with naratriptan. Cephalalgia 2000; 20: 122–6

    Article  PubMed  CAS  Google Scholar 

  8. Griffin NJ, Lipton RB, Silberstein SD, et al. Electronic diary study of premonitory symptoms in migraine. Presented at Headache World 2000; 2000 Sep 6; London

    Google Scholar 

  9. Farmer KU, Cady RK, Bleiberg J, et al. A pilot study to measure cognitive efficiency during migraine. Headache 2000; 40: 657–61 [See also Farmer K, Cady R, Bleiberg J, et al. Sumatriptan nasal spray and cognitive function during migraine: results of an open label study. Headache. In press]

    Article  PubMed  CAS  Google Scholar 

  10. Rozen TD, Swanson JW, Stang PE, et al. Increasing incidence of medically recognized migraine headache in a United States population. Neurology 1999; 53: 1468–73

    Article  PubMed  CAS  Google Scholar 

  11. Lipton RB, Stewart WF, Cady RK, et al. Sumatriptan for the range of headaches in migraine sufferers: results of the SPECTRUM Study. Headache 2000; 40: 783–91

    Article  PubMed  CAS  Google Scholar 

  12. Cady RK, Lipton RB, Hall C, et al. The treatment of mild headache in disabled migraine sufferers: results of the spectrum study. Headache 2000; 40: 792–7

    Article  PubMed  CAS  Google Scholar 

  13. Cady RK, Sheftell F, Lipton RB. Effect of early intervention with sumatriptan on migraine pain: retrospective analysis of data from three clinical trials. Clin Ther 2000; 49: 1035–48

    Article  Google Scholar 

  14. Becker G. Human capital. 3rd ed. Chicago (IL): Chicago University Press, 1993

    Google Scholar 

  15. Rice DP. Estimating the cost of illness. Washington, DC: US Government Printing Office, 1966: 20–39 (Health Economics Series No. 6, Public Health Service)

    Google Scholar 

  16. Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 14: 171–89

    Article  PubMed  CAS  Google Scholar 

  17. Wen CP, Tsai SP, Gibson RL. Anatomy of the healthy worker effect: a critical review. J Occup Med 1983; 25: 283–9

    PubMed  CAS  Google Scholar 

  18. Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology. Epidemiol Rev 1988; 10: 87–121

    PubMed  CAS  Google Scholar 

  19. Stang PE, Osterhaus JT, Celentano DD. Migraine: patterns of health care utilization. Neurology 1994; 44 Suppl. 4: S47–S55

    PubMed  CAS  Google Scholar 

  20. de Lissovoy G, Lazarus SS. The economic cost of migraine: present state of knowledge. Neurology 1994; 44 (6 Suppl. 4): S56–S62

    PubMed  Google Scholar 

  21. Solomon GD, Price KL. Burden of migraine: a review of its socioeconomic impact. Pharmacoeconomics 1997; 11 Suppl. 1: 1–10

    Article  PubMed  Google Scholar 

  22. Ferrari MD. The economic burden of migraine to society. Pharmacoeconomics 1998; 13 (6): 667–76

    Article  PubMed  CAS  Google Scholar 

  23. Fishman P, Von Korff M, Lozano P, et al. Chronic care costs in managed care. Health Aff (Millwood) 1997 May–Jun; 16 (3): 239–47

    Article  CAS  Google Scholar 

  24. Clouse JC, Osterhaus JT. Healthcare resource use and costs associated with migraine in a managed healthcare setting. Ann Pharmacother 1994; 28 (5): 659–64

    PubMed  CAS  Google Scholar 

  25. Osterhaus JT, Gutterman DL, Platchetka JR. Healthcare resource and lost labour costs of migraine headache in the US. Pharmacoeconomics 1992; 2 (1): 67–76

    Article  PubMed  CAS  Google Scholar 

  26. Cohen JA, Beall D, Beck A, et al. Sumatriptan treatment for migraine in a health maintenance organization: economic, humanistic, and clinical outcomes. Clin Ther 1999; 21: 190–204

    Article  PubMed  CAS  Google Scholar 

  27. The HCUP-3 Nationwide Inpatient Sample, Release 3. US Agency for Health Care Policy and Research, 1994 [online]. Available from: URL: http://www.informatics-online.com [Accessed 2000 May 1]

  28. Stang PE, VonKorff M, Galer BS. Reduced labor force participation among primary care patients with headache. J Gen Intern Med 1998; 13: 296–302

    Article  PubMed  CAS  Google Scholar 

  29. Fishman P, Black L. Indirect costs of migraine in a managed care population. Cephalalgia 1999; 19: 50–7

    Article  PubMed  CAS  Google Scholar 

  30. Von Korff M, Stang P. Prediction of the psychosocial and behavioral outcomes of headache in primary care. In: Oleson J, editor. Headache classification and epidemiology. New York (NY): Raven Press, 1995: 367–71

    Google Scholar 

  31. Von Korff M, Ormel J, Keefe FJ, et al. Grading the severity of chronic pain. Pain 1992; 50: 133–49

    Article  Google Scholar 

  32. Stewart WF, Lipton RB, Simon D, et al. Validity of an illness severity measure for headache in a population sample of migraine suffers. Pain 1999; 79: 291–301

    Article  PubMed  CAS  Google Scholar 

  33. Stewart WF, Lipton RB, Kolodner K, et al. Reliability of the migraine disability assessment score in a population-based sample of headache suffers. Cephalalgia 1999; 19: 107–14

    Article  PubMed  CAS  Google Scholar 

  34. Stang PE, Yanagihara T, Swanson JW, et al. The incidence of migraine headaches: a population-based study in Olmsted County, MN. Neurology 1992; 42: 1657–62

    Article  PubMed  CAS  Google Scholar 

  35. Centers for Diseases Control. Prevalence of chronic migraine headaches — United States, 1980–1989. MMWR Morb Mortal Wkly Rep 1991; 40: 331–8

    Google Scholar 

  36. Stang PE, Osterhaus JT. Impact of migraine in the United States: data from the National Health Interview Survey. Headache 1993; 33 (1): 29–35

    Article  PubMed  CAS  Google Scholar 

  37. Hu XH, Markson LE, Lipton RB, et al. Burden of migraine in the United States: disability and economic costs. Arch Intern Med 1999; 159; 813–8

    Article  PubMed  CAS  Google Scholar 

  38. Blau FD. Trends in the well-being of American women, 1970–1995. Cambridge (MA): National Bureau of Economic Research, 1997. Working Paper No. W6206.

    Google Scholar 

  39. Stang PE, Osterhaus JT. The epidemiology of migraine headache. In: Cady R, Fox A, editors. Treating the headache patient. New York (NY): Marcel Dekker, 1994: 41–60

    Google Scholar 

  40. Breslau N. Psychiatric comorbidity in migraine. Cephalalgia 1998; 18 Suppl. 22: 56–8

    PubMed  Google Scholar 

  41. Kessler RC, Frank RG. The impact of psychiatric disorders on work loss days. Psychol Med 1997; 27: 861–73

    Article  PubMed  CAS  Google Scholar 

  42. Dartigues JF, Michel P, Lindoulsi A, et al. Comparative view of the socioeconomic impact of migraine versus low back pain. Cephalalgia 1998; 18 Suppl. 21: 26–9

    PubMed  Google Scholar 

  43. Durham CF, Alden KR, Dalton JA, et al. Quality of life and productivity in nurses reporting migraine. Headache 1998; 38 (6): 427–35

    Article  PubMed  CAS  Google Scholar 

  44. Kryst S, Scherl E. A population-based survey of the social and personal impact of headache. Headache 1994; 34 (6): 344–50

    Article  PubMed  CAS  Google Scholar 

  45. Wagner TH, Patrick DL, Galer BS, et al. A new instrument to assess the long-term quality of life effects from migraine: development and psychometric testing of the MSQOL. Headache 1996; 36: 484–92

    Article  PubMed  CAS  Google Scholar 

  46. Stewart WF, Lipton RB, Simon D. Work-related disability: results from the American Migraine Study. Cephalalgia 1996; 16: 231–8

    Article  PubMed  CAS  Google Scholar 

  47. Schwartz BS, Stewart WF, Lipton RB. Lost workdays and decreased work effectiveness associated with headache in the workplace. Occup Environ Med 1997; 39: 320–7

    Article  CAS  Google Scholar 

  48. Von Korff M, Stewart WF, Simon DJ, et al. Migraine and reduced work performance: a population-based diary study. Neurology 1998; 50 (6): 1741–5

    Article  Google Scholar 

  49. Rasmussen BK, Jensen R, Olesen J. Impact of headache on sickness absence and utilization of medical services: a Danish population study. J Epidemiol Community Health 1992; 46: 443–6

    Article  PubMed  CAS  Google Scholar 

  50. Parry TG. The prevalence and costs of migraine in Australia. Center for Applied Economic Research Working Paper 1992/1. Sydney: University of New South Wales, 1992

    Google Scholar 

  51. Pryse-Phillips W, Findlay H, Tugwell P, et al. A Canadian population survey on the clinical, epidemiologic, and societal impact of migraine and tension-type headache, part II. Can J Neurol Sci 1992; 19: 333–9

    PubMed  CAS  Google Scholar 

  52. Mounstephen AH, Harrison RK. A study of migraine and its effects in a working population. Occup Med 1995; 45: 311–7

    Article  CAS  Google Scholar 

  53. Michel P, Dartigues JF, Lindoulsi A, et al. Loss of productivity and quality of life in migraine sufferers among French workers: results from the GAZEL cohort. Headache 1997; 37 (2): 71–8

    Article  PubMed  CAS  Google Scholar 

  54. Cortelli P, Dahlof C, Bouchard J, et al. A multinational investigation of the impact of subcutaneous sumatriptan: III. Workplace productivity and nonworkplace productivity. Pharmacoeconomics 1997; 11 Suppl. 1: 35–42

    Article  PubMed  Google Scholar 

  55. Legg RF, Sclar DA, Nemec NL, et al. Cost benefit of sumatriptan to an employer. J Occup Environ Med 1997; 39 (7): 652–7

    Article  PubMed  CAS  Google Scholar 

  56. Greiner DL, Addy SN. Sumatriptan use in a large group-model health maintenance organization. Am J Health Syst Pharm 1996; 53 (6): 633–8

    PubMed  CAS  Google Scholar 

  57. Lofland JH, Johnson NE, Batenhorst AS, et al. Changes in resource use and outcomes for patients with migraine treated with sumatriptan. Arch Intern Med 1999; 159: 857–63

    Article  PubMed  CAS  Google Scholar 

  58. Mushet GR, Miller D, Clements B, et al. Impact of sumatriptan on workplace productivity, nonwork activities, and health-related quality of life among hospital employees with migraine. Headache 1996; 36 (3): 137–43

    Article  PubMed  CAS  Google Scholar 

  59. Miller DW, Martin BC, Loo CM. Sumatriptan and lost productivity time: a time series analysis of diary data. Clin Ther 1996; 18 (6): 1263–75

    Article  PubMed  CAS  Google Scholar 

  60. Jhingran P, Cady RK, Rubino J, et al. Improvements in health-related quality of life with sumatriptan treatment for migraine. J Fam Pract 1996; 42 (1): 36–42

    PubMed  CAS  Google Scholar 

  61. Adelman JR, Sharfman M, Johnson R, et al. Impact of oral sumatriptan on workplace productivity, health related quality of life, healthcare use, and patient satisfaction with medication in nurses with migraine. Am J Manag Care 1996; 2: 1407–16

    Google Scholar 

  62. Cady RK, Ryan R, Jhingran P, et al. Sumatriptan injection reduces productivity loss during a migraine attack: results of a double-blind, placebo-controlled trial. Arch Intern Med 1998; 158 (9): 1013–8

    Article  PubMed  CAS  Google Scholar 

  63. Cady RK. Reduction of labor costs associated with treating migraine in the workplace [letter]. Arch Intern Med 1999; 159: 197

    Article  PubMed  CAS  Google Scholar 

  64. Osterhaus JT, Townsend RJ, Gandek B, et al. Measuring the functional status and well-being of patients with migraine headache. Headache 1994; 34: 337–43

    Article  PubMed  CAS  Google Scholar 

  65. Solomon GD. Evolution of the measurement of quality of life in migraine. Neurology 1997; 48 Suppl. 3: S10–S15

    Article  PubMed  CAS  Google Scholar 

  66. Dahlof C, Bouchard J, Cortelli P, et al. A multinational investigation of the impact of subcutaneous sumatriptan: II. Health related quality of life. Pharmacoeconomics 1997; 11 Suppl. 1: 24–34

    Article  PubMed  Google Scholar 

  67. Cohen JA, Beall DG, Miller DW, et al. Subcutaneous sumatriptan for the treatment of migraine: humanistic, economic, and clinical consequences. Fam Med 1996; 28: 171–7

    PubMed  CAS  Google Scholar 

  68. Lipton RB, Stewart WF, Simon D. Medical consultation for migraine: results from the American Migraine Study. Headache 1998; 38: 87–96

    Article  PubMed  CAS  Google Scholar 

  69. Stang PE, Von Korff M. The diagnosis of headache in primary care: factors in the agreement of clinical and standardized diagnoses. Headache 1994; 34: 138–42

    Article  PubMed  CAS  Google Scholar 

  70. Sauter SL, Lim S-Y, Murphy LR. Organizational health: a new paradigm for occupational stress research. Jpn J Occup Ment Health 1996; 4248–54

    Google Scholar 

  71. Warshaw LJ, Burton WN. Cutting the costs of migraine: role of the employee health unit. J Occup Environ Med 1998; 40 (11): 943–53

    Article  PubMed  CAS  Google Scholar 

  72. Warshaw LJ, Burton WN, Silberstein SD, et al. Migraine: a problem for employers and managed care plans. Am J Manage Care 1997; 3: 1515–23

    CAS  Google Scholar 

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Acknowledgements

We would like to thank the anonymous reviewers for their keen insights in substantially improving this work.

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Stang, P., Cady, R., Batenhorst, A. et al. Workplace Productivity. Pharmacoeconomics 19, 231–244 (2001). https://doi.org/10.2165/00019053-200119030-00002

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