Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2018

Open Access 01-12-2018 | Research article

Validation of a self-reported instrument to assess work-related difficulties in patients with migraine: the HEADWORK questionnaire

Authors: Alberto Raggi, Venusia Covelli, Erika Guastafierro, Matilde Leonardi, Chiara Scaratti, Licia Grazzi, Marco Bartolini, Giovanna Viticchi, Sabina Cevoli, Giulia Pierangeli, Gioacchino Tedeschi, Antonio Russo, Piero Barbanti, Cinzia Aurilia, Carlo Lovati, Luca Giani, Fabio Frediani, Paola Di Fiore, Francesco Bono, Laura Rapisarda, Domenico D’Amico

Published in: The Journal of Headache and Pain | Issue 1/2018

Login to get access

Abstract

Background

The degree to which work-related difficulties are recognized in headache research is poor and often carried out with inadequate information such as “reduced ability to work as usual”, which do not capture at all the variety of difficulties and the factors that impact over them. The aim of this paper is to present the validation of the HEADWORK questionnaire, which addresses the amount and severity of difficulties in work-related tasks and the factors that impact over them.

Methods

We developed a set of items based on a previous literature review and patients’ focus groups and tested it on a wide set of patients with episodic and chronic migraine attending eight different Italian headache centers. HEADWORK factor structure was assessed with exploratory and confirmatory factor analysis; internal consistency and construct validity were addressed as well.

Results

The validation sample (N = 373) was mostly composed of patients with episodic migraine without aura (64.3%) and of females (81%). Factor analysis retrieved two different scales: “Work-related difficulties”, composed of eleven items which explain 67.1% of the total variance, and “Factors contributing to work difficulties”, composed of six items which explain 52.1% of the total variance. Both HEADWORK subscales have good measurement properties, with higher scores being associated to higher disability, lower quality of life, lower productivity, higher headache frequency and pain intensity.

Conclusions

HEADWORK is a 17-item, two-scale questionnaire addressing the impact of migraine on work-related difficulties in terms of difficulties in general or specific skills, and the factors contributing to these difficulties, defined as negative impact on work tasks. It can be used to address disability weights for the purpose of calculating the burden of migraine, and to assess the balance between therapeutic and side effects of medication on productivity.
Appendix
Available only for authorised users
Literature
1.
Abu Bakar N, Tanprawate S, Lambru G, Torkamani M, Jahanshahi M, Matharu M (2016) Quality of life in primary headache disorders: a review. Cephalalgia 36:67–91CrossRefPubMed
2.
D'Amico D, Grazzi L, Usai S, Leonardi M, Raggi A (2013) Disability and quality of life in headache: where we are now and where we are heading. Neurol Sci 34:S1–S5CrossRefPubMed
3.
Raggi A, Giovannetti AM, Quintas R, D'Amico D, Cieza A, Sabariego C, Bickenbach JE, Leonardi M (2012) A systematic review of the psychosocial difficulties relevant to patients with migraine. J Headache Pain 13:595–606CrossRefPubMedPubMedCentral
4.
Lantéri-Minet M, Duru G, Mudge M, Cottrell S (2011) Quality of life impairment, disability and economic burden associated with chronic daily headache, focusing on chronic migraine with or without medication overuse: a systematic review. Cephalalgia 31:837–850CrossRefPubMed
5.
D'Amico D, Grazzi L, Usai S, Raggi A, Leonardi M, Bussone G (2011) Disability in chronic daily headache: state of the art and future directions. Neurol Sci 32:S71–S76CrossRefPubMed
6.
Buse DC, Rupnow MF, Lipton RB (2009) Assessing and managing all aspects of migraine: migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc 84:422–435CrossRefPubMedPubMedCentral
7.
Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27:193–210CrossRefPubMed
8.
Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, Lipton RB (2012) Chronic migraine prevalence, disability, and sociodemographic factors: results from the American migraine prevalence and prevention study. Headache 52:1456–1470CrossRefPubMed
9.
Ahmed F, Zafar HW, Buture A, Khalil M (2015) Does analgesic overuse matter? Response to OnabotulinumtoxinA in patients with chronic migraine with or without medication overuse. Springerplus 4:589CrossRefPubMedPubMedCentral
10.
Rojo E, Pedraza MI, Muñoz I, Mulero P, Ruiz M, de la Cruz C, Barón J, Rodríguez C, Herrero S, Guerrero AL (2015) Chronic migraine with and without medication overuse: experience in a hospital series of 434 patients. Neurologia 30:153–157CrossRefPubMed
11.
Aurora SK, Dodick DW, Turkel CC, RE DG, Silberstein SD, Lipton RB, Diener HC, Brin MF, PREEMPT 1 Chronic Migraine Study Group (2010) OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia 30:793–803CrossRefPubMed
12.
Rendas-Baum R, Bloudek LM, Maglinte GA, Varon SF (2013) The psychometric properties of the migraine-specific quality of life questionnaire version 2.1 (MSQ) in chronic migraine patients. Qual Life Res 22:1123–1233CrossRefPubMed
13.
14.
D'Amico D, Grazzi L, Curone M, Leonardi M, Raggi A (2017) Cost of medication overuse headache in Italian patients at the time-point of withdrawal: a retrospective study based on real data. Neurol Sci 38:S3–S6CrossRef
15.
Linde M, Gustavsson A, Stovner LJ, Steiner TJ, Barré J, Katsarava Z, Lainez JM, Lampl C, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Tassorelli C, Andrée C (2012) The cost of headache disorders in Europe: the Eurolight project. Eur J Neurol 19:703–711CrossRefPubMed
16.
Burton WN, Landy SH, Downs KE, Runken MC (2009) The impact of migraine and the effect of migraine treatment on workplace productivity in the United States and suggestions for future research. Mayo Clin Proc 84:436–445CrossRefPubMedPubMedCentral
17.
Stovner LJ, Hagen K (2006) Prevalence, burden, and cost of headache disorders. Curr Opin Neurol 19:281–285CrossRefPubMed
18.
Stang P, Cady R, Batenhorst A, Hoffman L (2001) Workplace productivity. A review of the impact of migraine and its treatment. Pharmacoeconomics 19:231–244CrossRefPubMed
19.
Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, Dodel R, Ekman M, Faravelli C, Fratiglioni L, Gannon B, Jones DH, Jennum P, Jordanova A, Jönsson L, Karampampa K, Knapp M, Kobelt G, Kurth T, Lieb R, Linde M, Ljungcrantz C, Maercker A, Melin B, Moscarelli M, Musayev A, Norwood F, Preisig M, Pugliatti M, Rehm J, Salvador-Carulla L, Schlehofer B, Simon R, Steinhausen HC, Stovner LJ, Vallat JM, Van den Bergh P, van Os J, Vos P, Xu W, Wittchen HU, Jönsson B, Olesen J, CDBE2010Study Group (2011) Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 21:718–779CrossRefPubMed
20.
Landy SH, Runken MC, Bell CF, Higbie RL, Haskins LS (2011) Assessing the impact of migraine onset on work productivity. J Occup Environ Med 53:74–81CrossRefPubMed
21.
Raggi A, Grazzi L, Grignani E, Leonardi M, Sansone E, Scaratti C, D'Amico D (2018) The use of MIDAS in patients with chronic migraine and medication-overuse headache: should we trust it? Neurol Sci 39:S125–S127CrossRef
22.
Raggi A, Leonardi M, Scaratti C, Sansone E, Grazzi L, D'Amico D (2018) Gender and education inequalities in the cost of medication-overuse headache. Neurol Sci 39:S117–S119CrossRef
23.
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. Neurol Sci 35:S23–S26CrossRef
24.
World Health Organization (2001) The international classification of functioning, disability and health. World Health Organization, Geneva
25.
Scaratti C, Raggi A, Leonardi M, Grazzi L, D’Amico D (2015) Work-related difficulties in patients with episodic and chronic migraine: a study protocol to define relevant themes. Neurol Sci 36:S174
26.
Headache Classification Committee of the International Headache Society (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808CrossRef
27.
Stewart WF, Lipton RB, Whyte J, Dowson A, Kolodner K, Liberman JN, Sawyer J (1999) An international study to assess reliability of the migraine disability assessment (MIDAS) score. Neurology 53:988–994CrossRefPubMed
28.
D’Amico D, Mosconi P, Genco S, Usai S, Prudenzano AM, Grazzi L, Leone M, Puca FM, Bussone G (2001) The migraine disability assessment (MIDAS) questionnaire: translation and reliability of the Italian version. Cephalalgia 21:947–952CrossRefPubMed
29.
Federici S, Bracalenti M, Meloni F, Luciano JV (2017) World Health Organization disability assessment schedule 2.0: an international systematic review. Disabil Rehabil 39:2347–2380CrossRefPubMed
30.
Martin BC, Pathak DS, Sharfman MI, Adelman JU, Taylor F, Kwong WJ, Jhingran P (2000) Validity and reliability of the migraine-specific quality of life questionnaire (MSQ version 2.1). Headache 40:204–215CrossRefPubMed
31.
Raggi A, Giovannetti AM, Schiavolin S, Leonardi M, Bussone G, Grazzi L, Usai S, Curone M, Di Fiore P, D'Amico D (2014) Validating the migraine-specific quality of life questionnaire v2.1 (MSQ) in Italian inpatients with chronic migraine with a history of medication overuse. Qual Life Res 23:1273–1277CrossRefPubMed
32.
Bagley CL, Rendas-Baum R, Maglinte GA, Yang M, Varon SF, Lee J, Kosinski M (2012) Validating migraine-specific quality of life questionnaire v2.1 in episodic and chronic migraine. Headache 52:409–421CrossRefPubMed
33.
Field A (2009) Discovering statistics using SPSS, third edn. Sage, London
34.
Hu L, Bentler PM (1994) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6:1–55CrossRef
35.
36.
Nunnally JC, Bernstein I (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York
37.
Leonardi M, Raggi A (2013) Burden of migraine: international perspectives. Neurol Sci 34:S117–S118CrossRefPubMed
38.
Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLD) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380:2163–2196CrossRefPubMed
39.
Global Burden of Disease Study (2013) Collaborators (2015) global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet 386:743–800
40.
41.
GBD (2016) Disease and injury incidence and prevalence collaborators (2017) global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet 390:1211–1259
42.
Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z (2018) Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain 19:17CrossRefPubMedPubMedCentral
43.
Headache Classification Committee of the International Headache Society (2018) The international classification of headache disorders, 3rd edition. Cephalalgia 38:1–211
44.
D'Amico D, Grazzi L, Curone M, Di Fiore P, Proietti Cecchini A, Leonardi M, Scaratti C, Raggi A (2015) Difficulties in work activities and the pervasive effect over disability in patients with episodic and chronic migraine. Neurol Sci 36: S9-S11
45.
Munakata J, Hazard E, Serrano D, Klingman D, Rupnow MF, Tierce J, Reed M, Lipton RB (2009) Economic burden of transformed migraine: results from the American migraine prevalence and prevention (AMPP) study. Headache 49:498–508CrossRefPubMed
46.
Lerner DJ, Amick BC 3rd, Malspeis S, Rogers WH, Santanello NC, Gerth WC, Lipton RB (1999) The migraine work and productivity loss questionnaire: concepts and design. Qual Life Res 8:699–710CrossRefPubMed
47.
Davies GM, Santanello N, Gerth W, Lerner D, Block GA (1999) Validation of a migraine work and productivity loss questionnaire for use in migraine studies. Cephalalgia 19:497–502CrossRefPubMed
48.
Reilly MC, Zbrozek AS, Dukes EM (1993) The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 4:353–365CrossRefPubMed
49.
Pradalier A, Auray JP, El Hasnaoui A, Alzahouri K, Dartigues JF, Duru G, Henry P, Lantéri-Minet M, Lucas C, Chazot G, Gaudin AF (2004) Economic impact of migraine and other episodic headaches in France: data from the GRIM2000 study. Pharmacoeconomics 22:985–999CrossRefPubMed
50.
51.
Tassorelli C, Diener HC, Dodick DW, Silberstein SD, Lipton RB, Ashina M, Becker WJ, Ferrari MD, Goadsby PJ, Pozo-Rosich P, Wang SJ; International Headache Society Clinical Trials Standing Committee (2018) Guidelines of the international headache society for controlled trials of preventive treatment of chronic migraine in adults. Cephalalgia 38: 815–832
52.
Gajria K, Lee LK, Flores NM, Aycardi E, Gandhi SK (2017) Humanistic and economic burden of nausea and vomiting among migraine sufferers. J Pain Res 10:689–698CrossRefPubMedPubMedCentral
53.
Lipton RB, Gandhi SK, Fitzgerald YPP, Cohen JM, Yang RH, Aycardi E (2017) The positive impact of fremanezumab on work productivity and activity impairment in patients with chronic migraine. In: Cephalalgia 37:S328-S329; meeting abstract PO-01-182
54.
55.
Metadata
Title
Validation of a self-reported instrument to assess work-related difficulties in patients with migraine: the HEADWORK questionnaire
Authors
Alberto Raggi
Venusia Covelli
Erika Guastafierro
Matilde Leonardi
Chiara Scaratti
Licia Grazzi
Marco Bartolini
Giovanna Viticchi
Sabina Cevoli
Giulia Pierangeli
Gioacchino Tedeschi
Antonio Russo
Piero Barbanti
Cinzia Aurilia
Carlo Lovati
Luca Giani
Fabio Frediani
Paola Di Fiore
Francesco Bono
Laura Rapisarda
Domenico D’Amico
Publication date
01-12-2018
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2018
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-018-0914-7

Other articles of this Issue 1/2018

The Journal of Headache and Pain 1/2018 Go to the issue

Research article

Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort

Research article

Abnormal brain white matter in patients with right trigeminal neuralgia: a diffusion tensor imaging study

Research article

Headache in transient ischemic attacks

Research

Pre-treatment with sumatriptan for cilostazol induced headache in healthy volunteers

Research article

Fremanezumab blocks CGRP induced dilatation in human cerebral, middle meningeal and abdominal arteries

Research article

Preventive effects of galcanezumab in adult patients with episodic or chronic migraine are persistent: data from the phase 3, randomized, double-blind, placebo-controlled EVOLVE-1, EVOLVE-2, and REGAIN studies