Migraine Therapy: A Survey of Pharmacists' Knowledge, Attitudes, and Practice Patterns


  • Richard G. Wenzel PharmD,

  • Richard B. Lipton MD,

  • Merle L. Diamond MD,

  • Roger Cady MD

  • From the Diamond Headache Clinic Inpatient Unit, Pharmacy Dept. St. Joseph Hospital, Chicago, Illinois (Dr. Wenzel); Albert Einstein College of Medicine, Department of Neurology, Epidemiology, and Social Medicine, Bronx, New York (Dr. Lipton); Diamond Headache Clinic, Chicago, Illinois (Dr. Diamond); and Headache Care Center, Springfield, Missouri (Dr. Cady).

Address all correspondence to Dr. Richard G. Wenzel, Diamond Headache Clinic Inpatient Unit, Pharmacy Dept. St. Joseph Hospital, Chicago, IL.


Objective.—Study pharmacists' knowledge, attitudes, and practice patterns with regard to migraine therapy.

Background.—Pharmacists interact with headache sufferers at least 53,000 times daily, thus are well positioned to improve the less than optimal medication management of these disorders.

Methods.—Two hundred self-administered surveys, distributed at a migraine symposium, assessing pharmacists' demographic characteristics and level of agreement or disagreement with treatment approaches were conducted.

Results.—A total of 171 useable surveys (86%) were received. Of the sample, 35% were community pharmacists, 29% were hospital pharmacists, and the remainder were from other work environments. Exclusively among community pharmacists, 80% feel that headache is an important part of their practice, 85% make between one and five over-the-counter (OTC) headache product suggestions per day, and 12% make six or more daily OTC recommendations. Among all the sample's pharmacists, more than half feel migraine patients should try OTC drugs prior to prescription medications, only half ask patients about headache-related morbidity, and one-third feel migraine-specific medications should be reserved only for patients who initially fail nonspecific drugs. Few pharmacists utilize published migraine treatment guidelines. Approximately two-thirds of pharmacists do not feel migraine is a neurobiological illness. The majority is comfortable with their ability to identify people needing a physician referral.

Conclusions.—Our results show pharmacists, particularly those in community pharmacies, interact with headache sufferers multiple times daily. Most pharmacists were neither familiar with nor practice migraine therapies endorsed by evidence-based guidelines. Further training of pharmacists is warranted.