Universiteit Leiden

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Research project

Migraine@Work: work ability in employees with migraine

This study aims to answer two main research questions:
(1) What are the main predictors of work ability in employees with migraine?
(2) Can we optimise work ability in employees with migraine using a web-based intervention focused on these relevant predictors?

Margot van der Doef

In collaboration with amongst others: Leiden University Medical Centre, Neurology department; TNO, expertise group Work, Health, and Technology; Hoofdpijnnet; Migrainefonds; Medical Delta, Ehealth programme; Tilburg University, Tranzo

Principal investigators: Margot van der Doef & Karin van der Hiele

Migraine is a chronic neurovascular disorder characterised by recurrent, pulsating headaches. The disorder affects 15% of the European population and is particularly prevalent amongst people of working age (Lipton & Bigal, 2005; Stovner & Andree, 2010). Estimates are that migraine leads to a yearly 3 to 7 days of work absence. The major part of lost work productivity in migraine however seems to be linked to reduced performance while at work, a phenomenon known as presenteeism, which is estimated to affect 6 to 10 workdays per year (Hoofdpijnpatiënten, 2013). Neurological disorders with episodic manifestations, such as migraine, have a unique impact on work ability. The disorder is generally invisible to the outside world, has an unpredictable nature, and despite its episodic nature, there is an often neglected interictal burden (Burton, Landy, Downs, & Runken, 2009). People with migraine may experience psychosocial and cognitive problems that interfere with work (Raggi et al., 2014; Raggi et al., 2012). Furthermore, societal stigma and discrimination among employers may contribute to difficulties in finding and maintaining employment (Young, Park, Tian, & Kempner, 2013). Little is known about the influence of psychological factors such as coping, illness perceptions, perceived stigma and work-related factors such as supervisor support and disclosure. The Migraine@Work study therefore aims to examine what cognitive, psychosocial and work-related factors influence work ability over time.

Based on this information, we will develop a web-based intervention aimed at optimising work ability in employees with migraine. There is currently no intervention aimed at optimising work ability in employees with migraine by improving self-management skills. The few interventions aimed at optimising work outcomes are tailored to the needs of employees with other chronic conditions (e.g. arthritis, cancer and common mental disorders). However, there are some web-based interventions that have proven to be effective in improving self-management skills in people with migraine (Bromberg et al., 2012; Sorbi, Kleiboer, van Silfhout, Vink, & Passchier, 2015). We plan to integrate effective elements from these interventions to create a web-based intervention aimed at optimising work ability in employees with migraine. In the development of the intervention, different stakeholders will be actively involved including employees with migraine, employers and occupational health professionals. The intervention will focus on improving self-management skills and will provide tools to manage the work situation. The intervention will be evaluated for its effectiveness and the final phase of the project will concern its implementation in practice.

Literature references

Bromberg, J., Wood, M. E., Black, R. A., Surette, D. A., Zacharoff, K. L., & Chiauzzi, E. J. (2012). A randomized trial of a web-based intervention to improve migraine self-management and coping. Headache, 52(2), 244-261.

Burton, W. N., Landy, S. H., Downs, K. E., & Runken, M. C. (2009). The impact of migraine and the effect of migraine treatment on workplace productivity in the United States and suggestions for future research. Mayo Clinic Proceedings, 84(5), 436-445. doi:10.1016/S0025-6196(11)60562-4.

Hoofdpijnpatiënten, N. V. v. (2013). Mensen met migraine ... aan het werk! Multidiscliplinaire evidence-based richtlijn. Retrieved from http://www.hoofdpijnpatienten.nl/brochures/richtlijnmigrainewerk/

Lipton, R. B., & Bigal, M. E. (2005). Migraine: epidemiology, impact, and risk factors for progression. Headache, 45 Suppl 1, S3-S13.

Raggi, A., Covelli, V., Leonardi, M., Grazzi, L., Curone, M., & D'Amico, D. (2014). Difficulties in work-related activities among migraineurs are scarcely collected: results from a literature review. Neurological Sciences, 35 Suppl 1, 23-26. doi:10.1007/s10072-014-1736-2

Raggi, A., Giovannetti, A. M., Quintas, R., D'Amico, D., Cieza, A., Sabariego, C., . . . Leonardi, M. (2012). A systematic review of the psychosocial difficulties relevant to patients with migraine. Journal of Headache and Pain, 13(8), 595-606. doi:10.1007/s10194-012-0482-1

Sorbi, M. J., Kleiboer, A. M., van Silfhout, H. G., Vink, G., & Passchier, J. (2015). Medium-term effectiveness of online behavioral training in migraine self-management: A randomized trial controlled over 10 months. Cephalalgia, 35(7), 608-618. doi:10.1177/0333102414547137

Stovner, L. J., & Andree, C. (2010). Prevalence of headache in Europe: a review for the Eurolight project. Journal of Headache and Pain, 11(4), 289-299. doi:10.1007/s10194-010-0217-0

Young, W. B., Park, J. E., Tian, I. X., & Kempner, J. (2013). The stigma of migraine. PloS One, 8(1), e54074. doi:10.1371/journal.pone.0054074


Van der Doef, M.P., & Schelvis, R.M.C. (2018). Relations between psychosocial job characteristics and work ability in employees with chronic headaches. Journal of Occupational Rehabilitation, 1-9. doi:10.1007/s10926-018-9769-7

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