Tool developed to get a grip on productivity

Characteristics identified as part of assessment

A team of researchers funded by AstraZeneca Pharmaceuticals based in Wilmington, DE, has completed a project aimed at developing a greater understanding of the characteristics and measurement of workplace productivity. The panel, composed of experts from the Office of Healthy Policy and Clinical Outcomes of Thomas Jefferson University in Philadelphia, and the American College of Occupational and Environmental Medicine (ACOEM) of Arlington Heights, IL, revealed their findings at ACOEM’s recent annual meeting in Chicago.

"Actually, the collaboration had a twofold intent," explains Ronald S. Leopold, MD, MPH, national medical director and vice president, Met Life Disability, Atlanta, and moderator of the Chicago panel. "One was to develop a measurement model of workplace productivity as it pertains to any and all injuries. The second was to specifically develop such tools for migraine headache."

A multi-pronged approach

What the researchers eventually came up with, says Leopold, was a multi-pronged approach to identify what the elements of productivity were, what the characteristics were, and then the best existing instruments to measure them.

The elements of productivity were put into three categories:

  • absenteeism (workers’ comp, short- and long-term disability, Family Medical Leave Act) and sick leave;
  • presenteeism (quality of work, quantity of work, and other personal factors);
  • turnover and replacement costs.

Next, the group measured a number of available tools. "They were evaluated based on their scientific merit, the applicability across industries and occupations and disease states and conditions, and whether or not they translated functionality into financial impact," says Leopold. "After they were identified, the different tools were put through an expert panel and scored."

The General Measurement Products selected were:

  • The Osterhaus Technique Work Limitations Questionnaire;
  • The MacArthur Health and Performance Questionnaire;
  • The Stanford/American Health Association Presenteeism Scale;
  • The Work Productivity and Activity Impairment Questionnaire;
  • The Employer Health Care Association of Tampa.

Migraine-specific products identified were:

  • The Work Productivity and Activity Impairment Questionnaire;
  • The Migraine Work and Productivity Loss Questionnaire.

AstraZeneca will use those tools identified as suited for migraine for their own continuing research. "I think in essence what they did was a decent job in identifying what’s out there," says Leopold, commenting on the panel’s work. "They used sound methodology and it was a good panel — many are colleagues I’m familiar with. They ended up making recommendations for tools that are very good."

The importance of migraine

It’s clear that AstraZeneca’s interest in migraine was based at least in part on products it either currently manufactures or has in the pipeline, but beyond that, should it be of significant concern to occupational health professionals? "Our short-term disability coverage begins after one week and lasts six months," notes Leopold. "For the 1 million covered lives we have, we have roughly 200–250 short-term disability claims for migraine headaches." This is based solely on ICD-9 codes. It does not include cluster or other severe headaches. "Typically, a bad headache does not warrant missing work for more than one week," Leopold points out.

Despite the fact that migraine is nowhere near the top 10 issues facing workers, it clearly impacts lots of people. "Migraines may not last that long, and many times people may be out for less than one week and we won’t see that in our statistics," Leopold explains. "So what we have only gives you the tip of the iceberg." And by their very nature, he says, migraines are going to be completely debilitating — especially for white-collar workers.

What’s more important than any specific condition is for occupational health professionals to pay more attention to issues of productivity, says Leopold. "Those of us in the occupational health profession subscribe to the belief that having a good working life is part of having a good life overall," Leopold says. "Many times we find ourselves at the point of assessing when a person can or should return to work and optimize their ability to work as best they can."

In terms of migraines, occupational health professionals should recognize that migraine headaches have a significant place in the working population, they are a disorder that can be treated, and that successful treatment is characterized by greatly improved productivity.

In terms of productivity in general, "Occupa-tional health professionals will no doubt be hearing more and more about productivity as years go by," Leopold predicts. "A lot of our large corporate customers are getting increasingly interested in measuring productivity. At ACOEM and the AAOHN, there is growing interest in the subject matter. It really is a niche that is ideally suited for occupational health."

[For more information contact: Ronald S. Leopold, MD, MPH, National Medical Director and Vice President, Met Life Disability, Atlanta. Telephone: (678) 319-2742. E-mail:]