The Novartis Migraine Survey found that 27% of sufferers in Malaysia said their headaches were severe while another 6% said the pain was incapacitating.
Most people who experience throbbing pain in the head tend to dismiss it as “just another headache”.
However, tension headaches and migraines are not something to be taken lightly, especially if they affect work productivity and quality of life.
Many of us lead fast-paced and demanding lifestyles that result in high levels of stress and anxiety which may trigger tension headaches and migraines.
The third most common health disorder in the world, migraine is a complex neurological condition that affects some three billion individuals and is increasingly recognised as having a profound effect on productivity and monetary loss in the workplace.
According to a research article in The Journal of Headache and Pain on the Impact of Migraine on Workplace Productivity and Monetary Loss conducted in June this year, approximately 86 million workdays are lost to migraines each year, costing £8.8bil in lost productivity in Britain.
In the United States, annual migraine-related costs per 1,000 employees are estimated at US$84,000 annually of which one-third is due to lost work time, In Singapore, S$1.04bil in economic losses was noted in 2018.
The last study done in Malaysia in 1996, as reported in The Journal of Head and Face Pain, indicated the prevalence of migraine was at 9%. There has been no new data documenting migraine or its effects on headache sufferers since then.
Migraine in Malaysia
In conjunction with Migraine Awareness Week 2020 this September, Novartis Malaysia teamed up with The Star to conduct a survey to help Malaysians living with migraine better understand their condition and empower them to take charge of their pain.
The survey, carried out in June this year, revealed that among headache sufferers, almost half of them get a headache at least once a week and many said the pain limited their daily activities for at least one day in the last three months.
About half of the headache sufferers may have migraine because 18% of the respondents said they get headaches once a week, 19% said at least two to three times a week, and 6% have headaches more than four times a week.
The number of people affected by migraine could also be rising as 20% admitted that their headaches were getting more frequent, indicating a worsening condition.
Survey respondents noticed that the onset of migraine came with warning symptoms such as dizziness or vertigo, nausea, flashes of light, partial vision loss or a numbness/tingling sensation while some said they had no warning signs at all.
Migraine sufferers often complain of severe pain affecting one side of the head, accompanied by feelings of nausea and bouts of vomiting and photophobia.
While they vary in terms of age and gender, the findings in The Journal of Headache and Pain study revealed that the majority of migraine sufferers are women (more than three times the prevalence compared to men) and most headache sufferers are working adults between the ages of 31 and 40.
The Novartis Migraine Survey indicated that 27% of headache sufferers said their headaches were severe while another 6% said the pain was incapacitating.
The survey also revealed that 50% of headache sufferers in Malaysia experienced limitations to their daily routine due to their headaches and about 50% of them were not able to fully enjoy life.
Some of them (12%) expressed that their headaches have stopped them from pursuing their dreams and ambitions.
Migraine can also take a toll on the individual’s social and family life. Personal relationships with parents, children and spouses suffer, while social activities are affected. Survey results showed that only 41% of sufferers felt understood by their families.
The substantial physical and psychological impact on individuals brought about by their pain can lead to a reduced quality of life, especially for those sufferers whose headaches recur more frequently.
Decline in work productivity
Findings from The Journal of Headache and Pain study clearly indicated that migraine affects productivity in the workplace here in Malaysia, causing an estimated 17 absent workdays annually.
The more frequent the migraine attacks, the more days employees are likely to be absent from work.
However, there seemed to be a higher prevalence in presenteeism compared to absenteeism. This meant that more employees show up for work despite being in pain, which not only causes productivity loss but results in health impairment and exhaustion.
This could be due to an element of guilt at play. This notion is further reinforced by the Novartis Migraine Survey results which showed that those suffering from migraine often felt bad for getting frequent headaches.
Up to 57% said their friends, colleagues and bosses did not understand their medical condition, and as such, migraineurs possibly felt obligated to continue working despite their inability to concentrate and be productive.
Rather than having measures to reduce absenteeism, the survey findings suggest that employers could instead develop health strategies and supportive work programmes to help employees affected by migraine manage and reduce their pain.
The benefits of having such strategies were apparent from an education and support programme held by Novartis Switzerland for its employees between June 2018 and October 2019.
The initiatives included education on migraine awareness, lectures by a neurologist, creating a migraine-friendly work environment, as well as monthly individualised coaching on migraine management and action plans from the telemedical nurse.
A significant improvement was shown in the long-term management of migraine, following the employer-sponsored disease management programme.
Approximately 90% of the participants in the Swiss programme reported that their condition improved after six months, and 86% after nine months.
Professional migraine management
From the Novartis Migraine Survey, it was found that the main issue lies in the fact that around half of all migraine sufferers do not know there are medications designed specifically to prevent and reduce migraine attacks.
Usually, headache sufferers in Malaysia resort to painkillers to manage their migraine and do not visit any healthcare professionals.
According to the Novartis Migraine Survey, over 53% of headache sufferers in Malaysia rely on painkillers to stop their headaches during a migraine attack, 27% avoid triggers while 15% do nothing at all.
Regular use of painkillers to treat headaches can cause the brain to develop a dependency towards the medication and induce “medication-overuse headaches”.
When the effect of the painkillers wears off, the headaches may return more intensely and cause the patient to consume even more painkillers.
This vicious cycle and overuse of painkillers will stop relieving pain after a while and may even lead to more migraine attacks.
Consistent with The Journal of Head and Pain study which said that half of migraine sufferers did not recognise their condition as something that needed treatment, the Novartis Migraine Survey results indicated that 64% felt their headaches were merely mild to moderate headaches.
Those who do seek healthcare tend to visit general practitioners while others resort to over-the-counter medication from pharmacies. Only 13% of sufferers go to a neurologist.
The Novartis Migraine Survey also revealed that most migraineurs think that the pain will pass and as such, do not bother to seek professional treatment.
This may be attributed to the fact that most migraine suffers (58%) have lived with the pain since they were young and have probably acclimatised to the condition.
This goes to show that migraine is often left undiagnosed and untreated despite its debilitating effects on work and quality of life.
The survey reaffirms that a considerable proportion of headache sufferers in Malaysia self-manage their headaches inaccurately, without seeking specialist treatment.
However, with the correct diagnosis, it is possible for preventative care to reduce headaches and ultimately, improve one’s quality of life.
Migraine should not be viewed as a stigma. There are many sufferers who battle the same pain daily, but that does not mean those afflicted have to live with the pain.
Speak to a neurologist to understand your migraine and develop a personalised treatment plan.
While there is no magic bullet, your neurologist can make recommendations to better manage your migraine.
