Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia

DOI: https://doi.org/10.1186/s10194- 020- 01144- z

Abstract-Summary Productivity and monetary loss due to migraine in the workplace may be substantial.

This study aimed to determine the impact of migraine on productivity and mon- etary lost among employees in the banking sectors, in a multiethnic middle income country.

Migraine-related disability (MIDAS) and headache frequency were recorded. Impact of migraine on work productivity and activities were evaluated using the

Work Productivity and Activity Impairment (WPAI) questionnaire.

The mean percent productivity loss at work (presenteeism) was almost 20-fold higher than the mean percent work time missed due to migraine (absenteeism) (39.1% versus 1.9%).

The mean percent productivity loss in regular activity (activity impairment) and overall work productivity loss (work impairment) was 38.4% and 39.9%, respectively.

Highest monetary loss related to presenteeism was reported in migraineurs with frequency of headache of above 3 days (MYR 25,691.2) (US$6176), whereas high- est monetary loss related to absenteeism was reported in migraineurs with MIDAS grade IV (MYR 12,369.1) (US$2973).

The significant impact of migraine on work productivity and regular activity, appears to lead to substantial monetary loss attributed to not only absenteeism, but more importantly to presenteeism.

This study also highlights the unmet needs in migraine management among

employees in the banking sector.

Extended: Another limitation is that the study’s sample size was small and there-

fore, findings should be validated by studies on a greater number of participants.

Introduction In the U.S., annual migraine-related costs for every 1000 employees are estimated to be US$84,000, of which one-third is attributable to lost work time.

The prevalence of migraine among workers in the banking sector in Asia country

has never been reported.

The banking sector is therefore particularly worthy of investigation [448] as the extent to which migraine impacts the health of workers in the banking industry remains unknown.

In the United States, estimated migraine-related absenteeism and presenteeism costs among the banking industry workers were $21.5 million and $24.4 million, respectively [449].

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1 Public Health

The economic impact of migraines on workers in the banking industry in Asia is

unknown.

The investigation aimed to determine the impact of migraine on (1) work produc- tivity and activity impairment and (2) costs lost attributed to absenteeism and presenteeism.

Methods The impact of migraine on work productivity and regular activities during the last 1 month was assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire.

Percent work time missed due to migraine (absenteeism)  =  [Hours of work missed due to migraine in last 1 month/(Hours of work missed due to migraine in last 1 month + Hours actually worked in the last 1 month)] * 100 Percent impair- ment while working due to migraine (presenteeism) = Degree of migraine affected work productivity in the last 1 month/10 * 100Subsequently, the cost lost associated with migraine due to absenteeism and presenteeism per year was calculated based on the WPAI results [450].

Estimated monetary value due to absenteeism per year = Individual payroll per person per hour (MYR) * 8 (working hours per day) * (Days of work missed due to migraine in the past three months) * 4 (For changing into the costs per a year).

Results Participants with MIDAS grade IV reported 3.9% (SD = 6.8) absenteeism.

Higher absenteeism was also observed among participants who reported having above three migraine days per month (2.8%) compared to those of 0–3 EM (1.8%) (Mann-Whitney U = 11,827.5, p = 0.002, Z = − 3.043).

Migraineurs with above three migraine days per month reported significantly higher presenteeism (49.5%, SD  =  27.2) than those of 0–3 EM (Mann-Whitney U = 11,659.0, p = 0.004, Z = − 2.877).

Days of work missed due to migraine in the last 3 months for overall participants

was 1.2 (SD = 3.9).

The estimated monetary loss due to absenteeism increased three-fold in partici- pants with MIDAS grade III (MYR4,900.7) [SD = 11,085.3] (US$1178) compared to those with MIDAS grade II (MYR1,575.9) [SD = 1823.4] (US$379).

Discussion This finding provides important information on the level of disability and frequency of migraine among employees in the banking sector and, as well, highlights the potential significant disease burden of migraine among groups with higher migraine disability and headache frequency.

The level of migraine disability, headache frequency and their associated employ- ees’ absenteeism found in the study highlights the importance for targeted interven- tions to reduce the burden of migraine on absenteeism.

The finding of 3.5-fold higher monetary loss due to presenteeism compared to absenteeism is consistent with other studies on the economic impact of migraine [11, 13, 44, 50, 90, 118, 131–443].

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Economics

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The remarkably higher average monetary loss due to presenteeism among indi- viduals with MIDAS grade IV (MYR 12,400 per year; US$3000), and in individuals with over three migraine days per month (MYR 25,000; USD6,000) provide insights into the high burden of presenteeism to organizations and underscore the impor- tance of policies to manage presenteeism .

Further, a small proportion of migraine sufferers with high disability and head- ache frequency who do not seek treatment but merely use over-the-counter medication.

Conclusion This study found a high burden of migraine among (bank) employees who responded to the survey and evidence of a considerable proportion of migraineurs with high disability and headache frequency who were under-diagnosed and hence undertreated.

The results provide a cost benchmark for organizations to assess potential sav- ings from interventions to reduce migraine and encourage appropriate treatment- seeking among the employees.

It also appears that currently, there is substantial unmet needs in migraine man-

agement among employees in the banking sector in our settings.

Acknowledgement A machine generated summary based on the work of Wong, Li Ping; Alias, Haridah; Bhoo-Pathy, Nirmala; Chung, Ivy; Chong, Yew Ching; Kalra, Sonesh; Shah, Zia U Bahkt Sultan. 2020 in The Journal of Headache and Pain.

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