Large-Scale Screening and Subsequent Effects of Migraine Treatment on the Work Floor in the Netherlands

• Published in: Cephalalgia 2009-06, Vol.29 (6), p.606-615
• Main Authors: Mérelle, SYM, Couturier, EGM, van Bokhorst, J, Busschbach, JJV, Passchier, J
• Format: Article
• Language: English
• Subjects: Adult; clinical trial; cost‐effectiveness; Cross-Over Studies; Efficiency - drug effects; Female; Humans; Male; Mass Screening - methods; Migraine; Migraine Disorders - diagnosis; Migraine Disorders - drug therapy; Patient Satisfaction; productivity; Pyrrolidines - therapeutic use; Quality of Life; screening; Serotonin Receptor Agonists - therapeutic use; Tryptamines - therapeutic use
• ISSN: 0333-1024; 1468-2982
• DOI: 10.1111/j.1468-2982.2008.01769.x

In a large retail business group the ID Migraine Screening Test was sent to employees with three or more absences from work in the past year (n = 2893). Employees with positive results were invited for a neurological consultation and migraine patients were randomly assigned to: first attack ‘treated as usual’ and the second attack treated with 40 mg eletriptan, or reversed order. Of the 2893 employees, 799 responded (28%), 260 were positively screened for migraine (33%), 84 patients were diagnosed by a neurologist and 41 of the 75 included patients completed the protocol. Eletriptan induced pain-free response in 33.3% of the patients at 4 h compared with 0% after ‘non-specific’ treatment (P = 0.03). Eletriptan also significantly improved quality of life, but differences in absence from work and productivity loss could not be detected. In conclusion, in-company screening can be beneficial for undertreated employees, but implementation obstacles can reduce the effectiveness of screening.