Effects on clinical status, patient behavior, and quality of life from a community pharmacist-led headache clinic focused on alternative treatments for chronic headache and migraine sufferers

Abstract

Objective: The purpose of this research is to discern the effects of a community pharmacist-led educational headache intervention on patient behaviors, changes in prescription and nonprescription medications, and changes in quality of life such as headache/migraine frequency, severity, and duration. Methods: This self-controlled, prepost study will involve a community pharmacist-led headache/migraine clinic at King Soopers Pharmacy in Thornton, Colorado. Patients will be recruited via direct advertisement and a subgroup of patients will be identified by whether they have had a prescription filled for an abortive migraine medication at store 68 in the past 6 months. Participants will be booked for a 30-minute appointment free of charge consisting of medication reconciliation, 15-minute PowerPoint presentation, a survey asking about their current condition, and the MSQv2.1 standardized quality of life questionnaire. Patients will be called via telephone 60 to 90 days post-intervention and asked questions similar to those they answered at baseline. Results: The aim of this study is to determine whether a community pharmacist- led educational intervention will improve outcomes for patients with headaches or migraines. We anticipate the results will reflect positive changes in patients' clinical status and quality of life as well as foster the patient-pharmacist relationship. We hope to see an increase in patients' involvement of self-care for their disease state and a willingness to try alternative treatments. It is estimated that the prevalence of headache-related disorders internationally in adults is 47%, making them one of the most frequent neurological ailments. Headaches and migraines remain among the top reasons patients see a physician and come into a community pharmacy to purchase nonprescription medications. Unlike diabetes, in which the cause of the disease is well understood, severe headache and migraine sufferers are largely unaware of precipitating factors and frequently turn to selftreatment options. Additionally, many complementary alternative medicines for headache and migraine are underused despite Level B or higher evidence supporting efficacy. A migraine-specific clinic has potential to be far reaching and aid in appropriate self-selection of nonprescription medications, reduce overuse of prescription abortive medications, decrease adverse drug reactions, expand clinical community pharmacy services, and improve the community pharmacist-patient relationship.