Migraine disorder: workplace implications and solutions.

Migraine disorder is disabling, costly, underdiagnosed, and undertreated. It affects employees' quality of life and ability to work or attend school, potentially decreasing their earning ability. Migraine disorder impacts the workplace substantially through absenteeism and presenteeism and increases health care costs. Although research on migraine disorder is expansive, no systematic research tool or design exists within population studies. This may account for the different prevalence rates seen, especially in African studies, which rely on verbal interviews instead of mail or telephone surveys. Women have a higher prevalence rate throughout the research, but they seek help more often than men. This may contribute to their higher rates, although hormones also play a role. Occupational health nurses can affect the outcome of migraine disorder for employees and employers. They can assist in identifying those employees with migraine disorder who are not diagnosed, those who have not investigated the various available medications, or the lifestyle changes that would decrease the intensity and frequency of migraine attacks. Research is needed to quantify the cost savings of workplace intervention in identifying employees with migraine disorder and its effect on absenteeism, presenteeism, and health care use. Occupational health nurses can determine the effectiveness of education by measuring motivation, lifestyle changes, and workplace modification against the intensity and frequency of migraine attacks. This, in turn, will yield measurable results in reducing absenteeism and presenteeism in the workplace. Occupational health nurses can spread this information through employees to their families. As more undiagnosed and undertreated individuals with migraine become educated and pursue diagnosis, treatment, and lifestyle changes, a measurable decrease in health care use and costs may occur. The economic impact of migraine disorder, in terms of workplace absenteeism and presenteeism and increased health care use by employees, continues to be of great concern. This impact may motivate employers to support workplace interventions that educate, screen, and refer migraineurs to appropriate care. Employers may also be motivated to request that a managed care model for migraine be included in health and welfare programs, which would allow for assignment of a nurse case manager with automatic referral to a neurologist. The workplace is an ideal environment for identifying and referring migraine sufferers who only self-treat for symptoms. Prompt and effective treatment, in and out of the workplace, will decrease the frequency and intensity of migraine attacks and increase the quality of life.