In some organizations, it makes sense to create a standalone employee migraine education program. The rationale for this can be determined by collecting basic demographics and self-reported data to better understand prevalence. Some employers look at claims data, including migraine diagnosis and drug utilization. Whatever the path, once a business case is established for developing a migraine management program, the next question is where to begin.

It’s important to start by setting program goals. These may include:

• Increase awareness about migraine and reduce related stigma
• Improve migraine diagnosis through education
• Provide information and resources that promote and support self-care for migraines, including lifestyle management
  • Seek out appropriate medical, lifestyle and pharmaceutical care
  • Better manage their migraine, including understanding triggers and treatment options

Keeping the messaging approachable and consumer-friendly while using multiple channels of communication is key to reaching the largest number of employees, including virtual workers. If possible, create content to educate program participants on migraine basics, diagnosis, treatment options, and lifestyle/trigger management using a multi-disciplinary team of migraine experts. Include health professionals such as primary care physicians, neurologists, pharmacists, registered dietitians and behavioral health specialists. Tap into your health plan, PBM, EAP and other vendors for expertise and resources.

Key Program Building Blocks

Data from Employees

• Employee health risk assessments (HRA) can support the collection of self-reported information about health status and lifestyle behaviors. Including questions about migraine and the needs of the employee population in this area to an existing HRA can be a simple way to get a snapshot of migraine prevalence and the related issues that need to be addressed.
• A baseline questionnaire can be given to all employees as a program opt-in tool. By using this type of tool, you cast the widest net and avoid related stigma by allowing anyone, regardless of migraine diagnosis, to participate. This tool can gather demographics (age, gender, work location), symptoms, migraine history, triggers, and treatments, including medication use. view an example
• A Work-Limitation-Questionnaire (WLQ) specific for migraines can be used to gather additional information from participating employees about day-to-day functioning at work and at home
• Technology, including mobile apps, can be used to collect self-reported data similar to that collected in the baseline questionnaire; can include elements of function such as health-related quality of life, and work/school/home absenteeism and presenteeism

Program Components

• A webinar series can provide on-demand information on a variety of topics to a wide audience; tap into the expertise available in your organization and through vendors to develop a regular series of webinars presented by different health professionals
• Monthly emails sent to participants to reinforce program resources, activities and information provided during webinars
• Posters/flyers and electronic message boards if available are a good way to reinforce messaging and get information out to a wide audience
• An intranet program website can help keep participants engaged in the program and up to date on the topic; use for program registration, webinars, additional content (can change monthly to keep people coming back)
• Individual one-on-one wellness consultations are a great way to encourage participants to talk about their specific issues (e.g. dietary triggers)
• Existing resources available in your organization can be packaged into the program, including onsite wellness/fitness centers, EAP counselors, registered dietitians and occupational health nurses

Incentives

• Incentives can add an element of fun to the program and promote engagement
• Don’t be afraid to be creative when using incentives in a migraine initiative
• Simple incentives can include raffles (e.g. fruit-of-the-month club for attending a webinar)
• Wellness points can be awarded to participation in various program components
• A point system can be used to offset health care premiums

Evaluation

• To determine program outcomes, a post-program survey/questionnaire can be given to all participants that may include questions about satisfaction with the program and whether the participant:
  • Consulted a doctor about their migraine
  • Made changes related to medications use
  • Consulted with an EAP counselor
  • Took action to decrease triggers for migraines
  • Engaged in relaxation and stress management techniques
• Providing an incentive can help to increase the survey return rate

Use the Pre and Post-program evaluation for an example of an evaluation tool.

Using Existing Programs & Resources

If resources are not available to create a new migraine program from scratch, it may make sense to incorporate migraine education and awareness into existing programs and initiatives.

Consider using wellness programs and/or onsite wellness and fitness centers to educate employees about migraine basics and support those suffering from migraine as they manage common triggers including diet, exercise, sleep and stress. Existing channels and resources can be used including onsite programs/staff, newsletters and company intranet for health education, skill building and coaching.

Employee Assistance Programs (EAP), in place to support the mental health and emotional well-being of employees, can also support those with migraine. According to the American Migraine Foundation, migraine patients are between two to five times more likely to have symptoms of stress and anxiety than patients without migraine. In fact, 50% - 60% of migraine patients suffer from an anxiety disorder and stress is a trigger in nearly 70% of those with migraine. If promoted effectively, the resources and services offered by an EAP could benefit those with migraine in significant ways, including support with identifying and managing migraine triggers such as stress.

Chronic condition management programs target individuals with a specific disease or condition and are typically data driven and focused on evidence-based, measurable outcomes. If your organization already has the structure in place to provide programs for chronic condition management, you may want to consider incorporating those diagnosed with migraine into the group. This can help them get properly diagnosed and treated. In addition, information to enhance self-care, so important to living a healthy and productive life with migraine, can be provided. With any disease management program, it is especially important to include continuing education and engagement activities for optimal success.