Role of the Workplace in Migraine Disease Management
Leon J. Warshaw
Wayne N. Burton
William J. Schneider
Migraine is a highly prevalent, nonfatal disorder typically characterized by recurrent episodes of headache associated with such symptoms as nausea, vomiting, photophobia, phonophobia and impaired functioning. The attacks may be infrequent and relatively mild; more often they are frequent, severe and disabling. They are 3 times more common in women than in men and occur most often between the ages of 25 and 45 years, the prime working years. As a result, the burden placed on employers and on society due to lost and impaired productivity is far greater than the not-inconsiderable costs of healthcare. A large variety of treatments are effective in aborting and in preventing or minimizing the attacks. Patients with migraine whose attacks are infrequent and mild do quite well on self-treatment with simple remedies. Those with attacks that are more frequent and severe require professional supervision and may need a long period of trial and error until a satisfactory regimen can be evolved. Unfortunately, a large proportion of patients with migraine, even some of those with severe attacks, have either not sought medical care or have been misdiagnosed and mismanaged. Particularly for these, disease management, an evolving strategy which features evidence-based treatment and continuing close collaboration between the patient with migraine and his/her physician, offers the best approach for control of this disease. Because of the high prevalence of migraine in the workforce and the burden of disruptions and/or impaired productivity that it places on the organization, the employer has a vested interest in using the workplace as an arena for activities (e.g. patient education and improving access to healthcare) that will contribute to the success of disease management in mitigating the impact of the disease.
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