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Researchers Develop Questionnaire to Assess Impact of Migraine on Work-Related Difficulties

Alison Rodriguez
Researchers 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.
Work-related difficulties and the variety in severity are often not investigated in headache research. A recent study, published by The Journal of Headache and Pain, presented the results of a HEADWORK questionnaire, which revealed the amount and severity of difficulties in work-related tasks and the factors that influence them.

The researchers evaluated a previous literature review and used patient focus groups that tested a wide set of patients with episodic and chronic migraine in order to develop a set of items to assess. The patient focus group data was collected from 8 different Italian headache centers. The study also considered sociodemographic data and self-reported tools, such as the HEADWORK questionnaire, which the researchers developed through their review.

“We therefore launched an initiative to develop a new questionnaire, the HEADWORK Questionnaire,” the authors stated. “Given the paucity of literature data, we ran a qualitative study with the aim of exploring which were the most relevant difficulties experienced by patients with their work activities and which were the factors that contributed most to these difficulties, getting indications directly from employed patients with [episodic migraine] and [chronic migraine].”
In total, the sample of patients included 373 individuals, with 64.3% of patients having episodic migraine without aura. The factor analysis used 2 scales, including “Work-related difficulties” and “Factors contributing to work difficulties.” The “Work-related difficulties” scale consisted of 11 items that explained 67.1% of the total variance, while “Factors contributing to work difficulties” consisted of 6 items that explained 52.1% of the total variance.

The HEADWORK subscales revealed higher scores were associated with higher disability, lower quality of life, lower productivity, and higher headache frequency and pain intensity.

“The HEADWORK questionnaire is likely to give an appropriate insight on the different dimensions of work-place difficulties in subjects with migraine in a clinical relevant period of time (one month.),” the authors explained. “It addresses not only the degree of work-related limitations, but also the impact on specific work tasks, and the evaluation of whole range of possible degree of impairment (by a scale from “no difficulty” to “I cannot do it”), thus offering an evaluation of the reduced work productivity while experiencing a migraine episode, which is the most relevant driver of the total costs of migraine.”

The researchers recommended using the HEADWORK questionnaire to measure the impact of migraine on work-related difficulties, however, further studies are needed in order to establish its role as an outcome tool and in order to test the validity of HEADWORK in other headache disorders.


Raggi A, Covelli V, Guastafierro E, et al. Validation of a self-reported instrument to assess work-related difficulties in patients with migraine: the HEADWORK questionnaire [published online September 10, 2018]. J Headache Pain. doi:

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