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Longitudinal Change in Migraine Headache-Days and Indirect Cost Consequences

Stewart, Walter F. PhD; Wood, G. Craig MS; Bruce, Christa MPH; Buse, Dawn C. PhD; Runken, M. Chris Pharm D; Lipton, Richard B. MD

Journal of Occupational and Environmental Medicine: May 2011 - Volume 53 - Issue 5 - p 478–487
doi: 10.1097/JOM.0b013e31821488ed
ORIGINAL ARTICLES: CME Available for this Article at

Objectives: To determine whether change in headache-days over 1-year is associated with change in lost productive time (LPT) among a population sample of migraineurs.

Methods: Data are from migraine sufferers who participated in at least two consecutive annual American Migraine Prevalence and Prevention surveys between 2005 and 2008. LPT was estimated using two questions from the validated Migraine Disability Assessment survey about missed workdays and number of days at work.

Results: The reduction in LPT (ie, missed workdays + reduced productive time) from 1 year to the next had a nonlinear relationship with reduction in headache-days. The relationship was directly linear, however, when change in employment status was considered in the regression model.

Conclusion: A reduction in headache days over time translates into a linear reduction in LPT, including an increased likelihood of employment.

From the Geisinger Clinic (Dr Stewart, Mr Wood, and Ms Bruce), Center for Health Research, Danville, PA; Department of Neurology (Drs Buse and Lipton), Albert Einstein College of Medicine, Bronx, NY; The Montefiore Headache Center (Drs Buse and Lipton) Montefiore Medical Center, Bronx, NY; and GlaxoSmithKline (Mr Runken), Research Triangle Park, NC.

Address correspondence to: Walter Stewart, PhD, Geisinger Clinic, Center for Health Research, MC 44-00,100 N. Academy Ave, Danville, PA 17822 (

Funding for this work was provided by a grant to the National Headache Foundation from Ortho-McNeil Neurologics, Inc., with additional funding provided by GlaxoSmithKline. Authors Walter Stewart, G. Craig Wood, Christa Bruce, Dawn C. Buse, M. Chris Runken, and Richard B. Lipton have no financial interested related to this research. Dawn Buse has served as a consultant to Merck and Allergan and has received honoraria from IROKO and MAP.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2011The American College of Occupational and Environmental Medicine