Impact of pharmacist interventions on seeking of medical care by migraineurs.

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.

Results: Of the 100 headache sufferers who participated in the study, 82 met International Headache Society criteria for migraine, of whom 22 were never consulters 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.

Conclusion: This 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.