title: The impact of a worksite migraine intervention program on work productivity, productivity costs, and non-workplace impairment among Spanish postal service employees from an employer perspective.
abstract: BACKGROUND
  Migraine is associated with a significant productivity loss to employers, who may benefit from making a migraine intervention available to their employees.
  
  
  OBJECTIVE
  To evaluate changes in migraine-related productivity and non-workplace impairment associated with a migraine intervention program from the employer perspective.
  
  
  METHODS
  This was a pre-test post-test study of Spanish Postal Service employees with migraine. The intervention consisted of counseling from occupational health physicians and rizatriptan 10 mg for symptomatic treatment of two subsequent migraine headaches. Physicians also prescribed additional medications for migraine prophylaxis, treatment of tension headaches, and rescue medications. Migraine-related work loss and non-workplace impairment (interference with daily and social activities) were self-reported at baseline (pre-intervention) and separately following each migraine headache (post-intervention) with the aid of a diary. Migraine-related work loss was reported as work loss due to absenteeism, reduced productivity while at work, and the sum of the two (total lost work day equivalents [LWDE]). An employer perspective was taken for the cost analysis, and thus productivity costs were the only costs considered.
  
  
  RESULTS
  A total of 436 patients comprised the population for analysis. The number of migraine-related LWDE per migraine attack were 0.48 days per migraine headache in the month before the intervention, decreasing to 0.20 days and 0.07 days per migraine headache during the first and second migraine headaches following the intervention (p < 0.0001 vs. baseline). Total migraine-related productivity costs per migraine headache were 34 euros/patient before the intervention, decreasing to 14 euros/patient and 5 euros/patient during the first and second headaches following the intervention (p < 0.0001). Non-workplace activity impairment was also significantly reduced (p < 0.0001) following the intervention. The main limitations of the study were the lack of a parallel control group and the potential for differential recall bias between the usual care and the intervention periods. In addition, the results may not be generalizable to other employers or other countries.
  
  
  CONCLUSIONS
  This study documents the value of a workplace migraine intervention program, which focused on migraine prevention and rizatriptan-based symptomatic treatment. It also highlights the important role occupational health clinics can play in helping employers and employees reduce the burden of migraine.
authors.affiliation: Correos y Telégrafos de España, Valencia, Spain.
authors.forename: Teofila
authors.initials: T
authors.lastname: Vicente-Herrero
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burke
authors.forename: Miguel J A
authors.initials: MJ
authors.lastname: Laínez
mesh_terms: D000041:Absenteeism; D000328:Adult; D003365:Costs and Cost Analysis; D003376:Counseling; D004526:Efficiency; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000191:economics* / Q000517:prevention & control / Q000628:therapy*; D009786:Occupational Health Services / Q000379:methods*; D011177:Postal Service; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D013030:Spain; D014230:Triazoles / Q000627:therapeutic use*; D014363:Tryptamines
chemical_list: D017366:Serotonin Receptor Agonists; D014230:Triazoles; D014363:Tryptamines; C093622:rizatriptan