The Community Pharmacist’s Role in Improving Migraine Care

Community pharmacists can play an integral role in chronic migraine treatment counseling and optimization, effectively decreasing overall health care costs while improving outcomes for patients, according to research presented at the American Society of Health-System Pharmacists (ASHP) 2020 Midyear Meeting and Clinical Exhibition.

During the virtual conference, Jillian M. Connolly, 2021 PharmD candidate at Northeastern University, presented the findings of a study evaluating the current state of migraine prophylaxis therapy and the role of community pharmacists in improving patient care.

According to Connolly, patients experiencing chronic migraine are indicated for preventive treatment of their migraine headaches. This preventive therapy is intended to reduce the frequency of migraines, severity of migraines, and the need for acute abortive therapy.

“Due to the variability in presentation and response of patients with migraines, treatment plans are highly individualized to account for specific factors,” the investigators wrote. As such, community pharmacists can aid in counseling, medication management and optimization, chronic condition management, and more.

For the study, the investigators performed a retrospective literature review of 12 studies from 4 databases on November 5, 2019.

Despite the efficacy of preventive migraine therapy, Connolly noted that “only 63% of patients with chronic migraine in 1 study were found to be taking the appropriate prophylactic therapy.”

According to Connolly, the studies analyzed all indicated ample opportunity for increased pharmacist involvement in the care of patients with migraine, particularly in regard to optimization of prophylactic medication therapy. Community pharmacist involvement can also enhance patient education about the disease state and non-pharmacologic strategies, as well as patient adherence to therapies.

From the analysis, the investigators identified 5 different roles that pharmacists can fill in improving care for patients with migraines:

• Identifying patients who are not optimally managed on current therapy,
• counseling patients on the proper use of their migraine medications,
• identifying patients with migraine disorders that are self-treating,
• decreasing health care costs for patients with migraines, and ultimately,
• decreasing the public health burden of migraine.

Overall, the investigators concluded from their review that patients with chronic migraines on prophylactic therapy may benefit from meeting with community-based pharmacists. Along with monitoring preventive therapy, pharmacists can work with providers to individualize therapy as migraine presentation can differ for patients and therapy should be personalized to the patients’ needs, they said.

Reference

Connolly J, Hoang B, Miller DM, Rose TN. Role of community-based pharmacists in the care of patients with migraines, a literature review. Presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 9, 2020. Accessed January 4, 2020.