Impact of pharmacist interventions on seeking of medical care by migraineurs

Abstract

Objectives: To determine the impact of a pharmacist-led educational intervention on the seeking of medical care from physicians by patients with migraine and identify barriers to migraine care and lapsing from this care.Design: Prospective, multigroup, quasiexperimental.Setting: Duquesne University in Pittsburgh, November 2004 through June 2005.Participants: 100 university employees and students. Information from the initial interview was used to divide the patients into four groups: (1) not a migraineur, (2) migraineur who is currently consulting a physician for care of headaches (current consulter), (3) migraineur who has not consulted with a physician for more than 12 months concerning headaches (lapsed consulter), and (4) migraineur who has never consulted a physician regarding headache (never consulter).Interventions: Verbal counseling by a pharmacist and written education on migraine, as well as self-administered questionnaires.Main outcome measures: Participants' physician consultation rates, perceived barriers to physician consultation, and perceived reasons for lapsing from care. ResultsOf the 100 headache sufferers who participated in the study, 82 met International Headache Society criteria for migraine, of whom 22 were never con- sulters and 20 were lapsed consulters. Cross-tabulation and chi-square statistics did not reveal any statistically significant differences between the never-consulter control and intervention groups for 3-month physician consultation rates or intention to seek consultation during the next 6 months; however, 64% of never consulters contacted their physician or expressed intentions to do so after the intervention. The top three barriers to physician consultation identified were misidentifying migraines as headaches (50%), satisfaction with current treatment (45%), and inconvenience of physician consultation (41%). The top three reasons for lapsing from care were reduced frequency of headache (40%), self-identification of effective therapy (40%), and physician-directed effective therapy (30%). Cross-tabulation and chi-square statistics revealed one significant difference among student/employee groups in their identification of barriers. ConclusionThis study identified barriers associated with migraineur physician consultation behavior and reasons for lapses in care. The role of pharmacists in encouraging migraineur physician consultation should be further examined.