Disability, quality of life, productivity impairment and employer costs of migraine in the workplace

DOI: https://doi.org/10.1186/s10194- 021- 01243- 5

Abstract-Summary There is a paucity of evidence on the impact of migraine and other headache disor- ders and the cost and productivity losses in the workplace.

The number of days when productivity at work was reduced by half or more

because of headache was significantly higher in migraine compared to TTH.

The economic loss due to absenteeism for migraine was calculated to be $ 238.3US$/year/person for day-off and 90.2US$/year/person for half-day off using migraine disability assessment score (MIDAS).

The economic loss due to presenteeism for migraine was calculated to be $ 375.4US$/year/person using MIDAS and 2217US$/year/person using work pro- ductivity and activity impairment questionnaire (WPAI).

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Estimated cost of productivity loss associated with presenteeism using WPAI

was calculated at 21.3 billion US$/year in Japan as a whole.

This study revealed a high prevalence and disease burden among employees with migraine that is associated with substantial losses in productivity and employer cost. These results support the development and implementation of workplace pro- grams to improve migraine management in the workplace and reduce the burden and costs associated with lost workplace productivity.

Extended: The number of day-off multiplied by the daily wage and the number of half-days off multiplied by 50% of the daily wage, and these were converted to annual amounts.

The economic loss due to absenteeism and presenteeism caused by headache was calculated using the age-specific wage in the IT industry according to the Basic Survey on Wage Structure in 2018 by the Ministry of Health, Labor and Welfare, since this survey was conducted in 2018 [428].

The economic loss due to presenteeism was calculated by multiplying the num- ber of the days when work productivity was reduced to less than half from MIDAS by wage multiplied by 0.5 and converted to annual amount.

We believe that quantitative assessment of the reduction in work productivity and

presenteeism due to headache should be possible in this homogeneous population.

Introduction Headache disorders are a public health concern due to their high prevalence, dis- ability and financial cost to society [429].

The World Health Organization estimates that the three most prevalent neuro- logic disorders worldwide are tension-type headache (1.5 billion), migraine (958.8 million) and medication overuse headache (58.5 million) [226].

Despite the prevalence and disability associated with migraine, many may be suffering in silence at work, resulting in loss of significant productivity in Asian countries with growing economies [430].

To initiate a public health approach to headache disorders, we deployed a research survey on prevalence rates and disease burden associated with headache in the workplace.

Workers of IT companies have been engaging in intellectual and cognitively challenging work and are considered to be a suitable population for our initial study on the impact on work productivity as a result of headache disorders.

Methods To estimate the economic loss due to headache, we calculated the number of days of headache, moderate or severe headache, the days off work due to headache, the half-days off work due to headache, and when work efficiency was reduced to less than half due to headache, using MIDAS.

The economic loss due to absenteeism and presenteeism caused by headache was calculated using the age-specific wage in the IT industry according to the Basic Survey on Wage Structure in 2018 by the Ministry of Health, Labor and Welfare, since this survey was conducted in 2018 [428].

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The economic loss due to presenteeism was calculated by multiplying the num- ber of the days when work productivity was reduced to less than half from MIDAS by wage multiplied by 0.5 and converted to annual amount.

When calculating the amount of economic loss due to presenteeism from WPAI data, we assumed that the degree of work efficiency decline was the same on days with headaches.

Results Statistically, the mean age of M and HA was significantly younger than TTH (p < 0.001, one-way ANOVA followed by Bonferroni’s post hoc test).

BMI of M was significantly lower than TTH (p = 0.049, one-way ANOVA fol-

lowed by Bonferroni’s post hoc test).

GH was significantly lower in M/TTH than NHA and in M than TTH and NHA

(p < 0.05, one-way ANOVA followed by Bonferroni’s post hoc test).

M, M/TTH and HA showed significantly higher values compared to TTH for lack of understanding of headaches in the workplace, impaired relationships due to headaches and burdening bosses and colleagues with headaches (p < 0.01, one-way ANOVA followed by Bonferroni’s post hoc test).

M and M/TTH showed significantly higher values compared to TTH and HA to lose their energy to work and not to concentrate on work due to headache (p < 0.01, one-way ANOVA followed by Bonferroni’s post hoc test).

Discussion This study revealed a high prevalence and disease burden among employees with migraine that is associated with substantial losses in productivity and employer cost. Amongst the 2458 respondents (98.5% of those surveyed) 17% had migraine, and compared to individuals with no headache or tension-type headache, people with migraine had significantly more missed workdays, and experienced a greater impact on work productivity, physical and mental health and economic cost to the employer.

Using economic loss due to migraine and working population data from the Statistics Bureau of Japan, the annual economic loss due to presenteeism is US $3.3 billion, calculated from the number of days when work efficiency has fallen to less than half due to headaches using MIDAS.

This suggests that migraine may have an impact on work efficiency and eco-

nomic losses even on days without headache.

Conclusions This employee population survey revealed a high prevalence and disease burden of migraine that is associated with substantial losses in productivity and employer cost. These results support the development and implementation of workplace pro- grams to improve migraine management in the workplace and reduce the burden and costs associated with lost workplace productivity.

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Acknowledgement A machine generated summary based on the work of Shimizu, Toshihiko; Sakai, Fumihiko; Miyake, Hitoshi; Sone, Tomofumi; Sato, Mitsuhiro; Tanabe, Satoshi; Azuma, Yasuhiro; Dodick, David W. 2021 in The Journal of Headache and Pain.

Migraine treatment and healthcare costs: retrospective analysis of the China Health Insurance Research Association (CHIRA) database