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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Migraine Education Reduces Costs to Employers |
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BY DON SCHRADER
Contributing Writer |
CHICAGO (ECCC)—Educating employees with migraine about their condition may help
reduce absenteeism, loss of productivity, and healthcare costs, data from a pilot program suggest.
Six months after completion of an Internet-based migraine education program, employees at three different work sites had significantly fewer lost work days and lost work hours compared with the three months before the program, reported Matthew J. Page, a health policy analyst for United BioSource Corp. in Bethesda, Md., on April 17 at the annual meeting of the American Academy of Neurology. Page pointed out that although direct costs for migraine care actually increased, they were offset by large reductions in indirect costs.
“Recognizing the limitations of self-reported recall and the low participation in the follow-up survey, these findings suggest that an educational program for employees can help reduce employer costs associated with migraine and other headache disorders,” said Page. “We observed improvement in various factors that contribute to direct and indirect costs, but the decrease in indirect costs was especially striking.”
A recent study indicated that the direct cost burden of migraine in the United States surpasses $11 billion annually (Headache. 2008;48:553-563). The estimated indirect costs of migraine approach $12 billion a year (J Occup Environ Med. 2007:49:368-374). Presenteeism (work hours affected by headache and loss of productivity) accounts for 90% of the indirect costs of headache (J Occup Environ Med. 2004;46:398-412).
Whether an employer-provided educational program could reduce migraine-related costs and productivity loss had not been carefully examined.
Page and his colleagues invited employees from three U.S. worksites to visit a company-specific Web site that briefly described the study and included a six-question migraine-screening instrument that employees could choose to complete. Respondents who answered “yes” to the first question (diagnosis) and to four of the five screening questions were invited to participate in the study.
Study participants completed a survey that elicited information about migraine frequency and severity. They also answered questions about use of healthcare resources.
At regular intervals, participants received three emails containing educational materials. They also received six migraine-related newsletters at 2-week intervals.
Six months after receiving the last email of educational materials, study participants completed a follow-up survey. The baseline and follow-up surveys had a 3-month recall period. Investigators estimated costs from employees’ responses to the surveys.
For the three worksites combined, 1,463 completed the online screening instrument, and 1,152 qualified to participate in the study. Two thirds of the qualifying respondents had both a migraine diagnosis and positive responses to the screening instrument. Page reported that 917 of the qualifiers completed the baseline survey. However, only 247 of the 917 (27%) completed the follow-up survey, greatly reducing the generalizability of the study findings.
Both migraine frequency and severity decreased significantly following the educational intervention (P=0.0001, P<0.0001). Use of medications and alternative therapies did not change during the study. Physician office visits decreased significantly (P=0.0374), but visits to emergency rooms increased, though not significantly.
Lost work days due to migraine decreased significantly from 800 per 1,000 persons in the 3 months before the educational program to 600 per 1,000 in the first 3 months after completion of the program (P=0.0053). The proportion of participants who missed at least 1 day of work because of migraine decreased from 41% to 29%. The number of hours affected by headache remained stable, but self-assessed productivity increased significantly (P=0.0001).
Estimated direct costs increased from $105,220 per 1,000 migraineurs to $169,780 per 1,000. The increase was driven by increased expenditures for emergency room visits and hospitalizations. Costs associated with physician visits declined.
Indirect costs decreased from $403,250 per 1,000 migraineurs in the 3 months before baseline to $264,160 per 1,000 at follow-up (P<0.0001). Both absenteeism and presenteeism decreased substantially.
Total costs (direct and indirect combined) decreased from $508,470 per 1,000 migraineurs to $433,940 per 1,000 (P<0.0001). |
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