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Baratta F, Allais G, Gnavi R, Scarinzi C, Enri LR, Rolando S, Spadea T, Costa G, Benedetto C, Mana M, Giaccone M, Mandelli A, Manzoni GC, Bussone G, Brusa P. Triptans utilization in Italian population: A real-life study in community pharmacies. PLoS One 2023; 18:e0291323. [PMID: 37682959 PMCID: PMC10490971 DOI: 10.1371/journal.pone.0291323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
The term Headache Disorders (HD) refers to a number of nervous system pathologies characterised by recurrent headaches. Despite the serious impact HD have on the health system, society, and the economy, these are an underestimated, underdiagnosed, and, hence, undertreated phenomenon. Triptans are the first-line therapy for the acute treatment of moderate to severe migraine but their utilization is still inadequate, perhaps also because in Italy no triptan can be bought without a medical prescription. In this article, the data from a 2016-2017 study has been further analysed with the aim of evaluating any associations between the use of triptans and the other series of variables identified in the questionnaire. This further analysis has been connected to the role that community pharmacies could play on this issue. The questionnaire was administered to 4,424 pharmacy users by 610 purposely trained pharmacists working in 514 pharmacies. The survey was carried out in 19 of the 20 Italian regions. The data shows that only 25% of patients suffering from HDs are prescribed triptans. Older patients, those with definite migraines, and those with a chronic disorder resort more frequently to this class of pharmaceuticals, as do those patients in care at a specialist headache centre. The multivariable analysis also confirmed these results. Our study, which performed a direct detection, in real life, on patients requesting pharmacological treatment for a migraine headache, therefore confirmed the need to investigate the reasons behind the low use and prescription of triptans in the Italian population. Moreover, any future studies should take advantage of community pharmacies, plan actions that would allow a series of evaluations over time of the requirements of migraineurs, and establish a process to put these patients under the care of the pharmacy to ensure adherence to therapy.
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Affiliation(s)
- Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Gianni Allais
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
- FI.CEF Onlus, Italian Headache Foundation, Milan, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | | | | | - Sara Rolando
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | - Teresa Spadea
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | | | - Chiara Benedetto
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | | | - Mario Giaccone
- Order of Pharmacists of Turin, Turin, Italy
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | | | | | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Turin, Italy
- Order of Pharmacists of Turin, Turin, Italy
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Marupuru S, Almatruk Z, Slack MK, Axon DR. Use of Pharmacological and Non-Pharmacological Strategies by Community-Dwelling Adults to Manage Migraine: A Systematic Review. Clin Pract 2023; 13:553-568. [PMID: 37218802 DOI: 10.3390/clinpract13030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/13/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Migraine is a prevalent disease associated with high levels of disability and is often underdiagnosed and undertreated. This systematic literature review aimed to identify the types of pharmacological and non-pharmacological strategies that community-dwelling adults report using to manage migraine. A systematic literature review of relevant databases, grey literature, websites, and journals was conducted from 1 January 1989 to 21 December 2021. Study selection, data extraction, and risk of bias assessment were completed independently by multiple reviewers. Data were extracted on migraine management strategies and categorized as opioid and non-opioid medications and medical, physical, psychological, or self-initiated strategies. A total of 20 studies were included. The sample sizes ranged from 138 to 46,941, with a mean age of 34.7 to 79.9 years. The data were typically collected using self-administered questionnaires (nine studies), interviews (five studies), online surveys (three studies), paper-based surveys (two studies), and a retrospective database (one study). Community-dwelling adults with migraine reported they primarily used medications, specifically triptans (range 9-73%) and non-steroidal anti-inflammatory drugs (NSAIDs) (range 13-85%) to manage migraine. Except for medical strategies, the use of other non-pharmacological strategies was low. Common non-pharmacological strategies included consulting physicians (range 14-79%) and heat or cold therapy (35%).
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Affiliation(s)
- Srujitha Marupuru
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
| | - Ziyad Almatruk
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, P.O. Box 80200, Jeddah 21589, Saudi Arabia
| | - Marion K Slack
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
| | - David R Axon
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
- Center for Health Outcomes and PharmacoEconomic Research (HOPE Center), R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
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3
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Perrot S, Trouvin AP, Clairaz-Mahiou B, Tempremant G, Martial F, Brément D, Cherkaoui A. A Computerized Pharmacy Decision Support System (PDSS) for Headache Management: Observational Pilot Study. Interact J Med Res 2022; 11:e35880. [PMID: 36427228 PMCID: PMC9736760 DOI: 10.2196/35880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/30/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Headaches are common and often lead patients to seek advice from a pharmacist and consequently self-medicate for relief. Computerized pharmacy decision support systems (PDSSs) may be a valuable resource for health care professionals, particularly for community pharmacists when counseling patients with headache, to guide treatment with over-the-counter medications and recognize patients who require urgent or specialist care. OBJECTIVE This observational pilot study aimed to evaluate a newly developed PDSS web app for the management of patients seeking advice from a pharmacy for headache. This study examined the use of the PDSS web app and if it had an impact on patient or pharmacy personnel counseling, pharmacy personnel perception, and patient perception. METHODS The PDSS web app was developed according to Francophone des Sciences Pharmaceutiques Officinales (SFSPO) recommendations for headache management, and was made available to pharmacies in 2 regions of France: Hauts de France and New Aquitaine. Pharmacy personnel received 2 hours of training before using the PDSS web app. All people who visited the pharmacies for headache between June 29, 2020, and December 31, 2020, were offered an interview based on the PDSS web app and given information about the next steps in the management of headaches and advice on the proper use of their medication. Patients and pharmacy personnel reported satisfaction with the PDSS web app following consultations or during a follow-up period (January 18 to 25, 2021). RESULTS Of the 44 pharmacies that received the PDSS web app, 38 pharmacies representing 179 pharmacy personnel used the PDSS web app, and 435 people visited these pharmacies for headache during the study period. Of these, 70.0% (305/435) asked for immediate over-the-counter analgesics for themselves and consulted with pharmacy personnel with the use of the PDSS web app. The majority of these patients were given advice and analgesics for self-medication (346/435, 79.5%); however, 17.0% (74/435) were given analgesics and referred to urgent medical services, and 3.5% (15/435) were given analgesics and referred to their general practitioner. All pharmacy personnel (n=45) were satisfied or very satisfied with the use of the PDSS web app, and a majority thought it improved the quality of their care (41/44, 93.2%). Most pharmacy personnel felt that the PDSS web app modified their approach to management of headache (29/45, 64.4%). Most patients were very satisfied with the PDSS web app during their consultation (96/119, 80.7%), and all felt mostly or completely reassured. CONCLUSIONS Use of the PDSS web app for the management of patients with headache improved the perceived quality of care for pharmacy personnel and patients. The PDSS web app was well accepted and effectively identified patients who required specialist medical management. Further studies should identify additional "red flags" for more effective screening and management of patients via the PDSS web app. Larger studies can measure the impact of the PDSS web app on the lives of patients and how safe or appropriate pharmacy personnel recommendations are.
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Affiliation(s)
- Serge Perrot
- Centre de la douleur, Hôpital Cochin, Paris, France
| | | | | | - Grégory Tempremant
- Regional Unions of Health Professionals, Pharmaciens Hauts-de-France, Lille, France
| | - François Martial
- Regional Unions of Health Professionals, Pharmaciens Nouvelle Aquitaine, Bordeaux, France
| | | | - Asmaa Cherkaoui
- Public Affairs, Sanofi Consumer Healthcare, Gentilly, France
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4
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Treatment of migraine: a review of disease burden and an update on the therapeutic landscape for pharmacists. DRUGS & THERAPY PERSPECTIVES 2020. [DOI: 10.1007/s40267-020-00801-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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5
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Downie AS, Hancock M, Abdel Shaheed C, McLachlan AJ, Kocaballi AB, Williams CM, Michaleff ZA, Maher CG. An Electronic Clinical Decision Support System for the Management of Low Back Pain in Community Pharmacy: Development and Mixed Methods Feasibility Study. JMIR Med Inform 2020; 8:e17203. [PMID: 32390593 PMCID: PMC7248808 DOI: 10.2196/17203] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 12/12/2022] Open
Abstract
Background People with low back pain (LBP) in the community often do not receive evidence-based advice and management. Community pharmacists can play an important role in supporting people with LBP as pharmacists are easily accessible to provide first-line care. However, previous research suggests that pharmacists may not consistently deliver advice that is concordant with guideline recommendations and may demonstrate difficulty determining which patients require prompt medical review. A clinical decision support system (CDSS) may enhance first-line care of LBP, but none exists to support the community pharmacist–client consultation. Objective This study aimed to develop a CDSS to guide first-line care of LBP in the community pharmacy setting and to evaluate the pharmacist-reported usability and acceptance of the prototype system. Methods A cross-platform Web app for the Apple iPad was developed in conjunction with academic and clinical experts using an iterative user-centered design process during interface design, clinical reasoning, program development, and evaluation. The CDSS was evaluated via one-to-one user-testing with 5 community pharmacists (5 case vignettes each). Data were collected via video recording, screen capture, survey instrument (system usability scale), and direct observation. Results Pharmacists’ agreement with CDSS-generated self-care recommendations was 90% (18/20), with medicines recommendations was 100% (25/25), and with referral advice was 88% (22/25; total 70 recommendations). Pharmacists expressed uncertainty when screening for serious pathology in 40% (10/25) of cases. Pharmacists requested more direction from the CDSS in relation to automated prompts for user input and page navigation. Overall system usability was rated as excellent (mean score 92/100, SD 6.5; 90th percentile compared with similar systems), with acceptance rated as good to excellent. Conclusions A novel CDSS (high-fidelity prototype) to enhance pharmacist care of LBP was developed, underpinned by clinical practice guidelines and informed by a multidisciplinary team of experts. User-testing revealed a high level of usability and acceptance of the prototype system, with suggestions to improve interface prompts and information delivery. The small study sample limits the generalizability of the findings but offers important insights to inform the next stage of system development.
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Affiliation(s)
- Aron Simon Downie
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Faculty of Science and Engineering, Macquarie University, Macquarie Park, Australia
| | - Mark Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Christina Abdel Shaheed
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Andrew J McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ahmet Baki Kocaballi
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Australia.,Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
| | - Christopher M Williams
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Zoe A Michaleff
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Chris G Maher
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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6
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Rota E, Zucco R, Guerzoni S, Cainazzo MM, Pini LA, Catarci T, Granella F. Migraine Awareness in Italy and the Myth of “Cervical Arthrosis”. Headache 2019; 60:81-89. [DOI: 10.1111/head.13679] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Eugenia Rota
- Neurology Unit ASL Alessandria Novi Ligure Italy
| | - Riccardo Zucco
- Unit of Neurology Neuromotor Department Arcispedale SMN – IRCCS Reggio Emilia Italy
| | - Simona Guerzoni
- Medical Toxicology – Headache Center AOU Policlinico Modena Modena Italy
| | - Maria M. Cainazzo
- Medical Toxicology – Headache Center AOU Policlinico Modena Modena Italy
| | - Luigi A. Pini
- Medical Toxicology – Headache Center AOU Policlinico Modena Modena Italy
| | - Teresa Catarci
- Neurology Department Azienda Sanitaria Locale Roma 1 Rome Italy
| | - Franco Granella
- Unit of Neurology Department of Medicine and Surgery University of Parma Parma Italy
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7
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Baratta F, Allais G, Rolando S, Manzoni GC, Bussone G, Benedetto C, Scarinzi C, Gnavi R, Spadea T, Costa G, Parente M, Mana M, Giaccone M, Mandelli A, Brusa P. Prevention, education and counselling: the worldwide role of the community pharmacist as an epidemiological sentinel of headaches. Neurol Sci 2019; 40:15-21. [PMID: 30854588 DOI: 10.1007/s10072-019-03794-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Headache disorders are the third among the worldwide causes of disability, measured in years of life lost to disability. Given the pharmacies' importance in general in headache patient and, in particular in migraine patient management, various studies have been carried out in recent years dealing with this issue. Indeed, in 2014, our research group first analysed publications on a number of studies conducted worldwide. As five years have passed since our first analysis of the literature and having carried out a number of specific studies in Italy since 2014, we wish to analyse once again the studies carried out globally on this topic to evaluate how the situation has evolved in the meantime. The key words used for the bibliographic search were "community pharmacy" and "headache"; we considered articles published between 2014 and 2018. The selected studies regarded Sweden USA, Belgium, Ireland, Jordan and Ethiopia. From the analysis of the international research papers, it is evident that, despite the time that has passed since the previous analyses and the general agreement that pharmacists find themselves in an ideal position to offer adequate levels of counselling to headache patients, the knowledge of pharmacists is not yet sufficient. Clearly, there is a strong need to develop training programmes specifically focused on this subject. Regarding Italy, a national study, commenced in 2016, was designed as a cross-sectional survey employing face-to-face interviews between pharmacist and patient using a questionnaire drawn up by experts in compliance with best practice from scientific literature. Six hundred ten pharmacists followed a specific training course; 4425 questionnaires were correctly completed. The use of pharmacies as epidemiological sentinels, given their capillarity and daily contact with the local population in Italy, enabled us to obtain an epidemiological snapshot closer to the real-life situation compared to specialist headache centres. Over the course of this study, data on headaches were gathered in Italian pharmacies with the highest levels of numerosity in the world.
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Affiliation(s)
- Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy.
| | - Gianni Allais
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy.,FI.CEF. onlus, Italian Headache Foundation, via Celoria 11, 20133, Milan, Italy
| | - Sara Rolando
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | | | - Gennaro Bussone
- FI.CEF. onlus, Italian Headache Foundation, via Celoria 11, 20133, Milan, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Cecilia Scarinzi
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Teresa Spadea
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Giuseppe Costa
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Marco Parente
- Federfarma Torino, Via Sant'Anselmo, 14, 10125, Turin, Italy
| | - Massimo Mana
- Federfarma Piemonte, Via Sant'Anselmo, 14, 10125, Turin, Italy
| | - Mario Giaccone
- Order of Pharmacists of Turin, Via Sant'Anselmo, 14, 10125, Turin, Italy.,FOFI, Federation of the Orders of Italian Pharmacists, Via Palestro 75, 00185, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Via Palestro 75, 00185, Rome, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy.,Order of Pharmacists of Turin, Via Sant'Anselmo, 14, 10125, Turin, Italy
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8
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Baratta F, Allais G, Rolando S, Manzoni GC, Bussone G, Benedetto C, Scarinzi C, Gnavi R, Spadea T, Costa G, Parente M, Mana M, Giaccone M, Mandelli A, Brusa P. Prevention, education and counselling: the worldwide role of the community pharmacist as an epidemiological sentinel of headaches. Neurol Sci 2019. [PMID: 30854588 DOI: 10.1007/s10072‐019‐03794‐7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Headache disorders are the third among the worldwide causes of disability, measured in years of life lost to disability. Given the pharmacies' importance in general in headache patient and, in particular in migraine patient management, various studies have been carried out in recent years dealing with this issue. Indeed, in 2014, our research group first analysed publications on a number of studies conducted worldwide. As five years have passed since our first analysis of the literature and having carried out a number of specific studies in Italy since 2014, we wish to analyse once again the studies carried out globally on this topic to evaluate how the situation has evolved in the meantime. The key words used for the bibliographic search were "community pharmacy" and "headache"; we considered articles published between 2014 and 2018. The selected studies regarded Sweden USA, Belgium, Ireland, Jordan and Ethiopia. From the analysis of the international research papers, it is evident that, despite the time that has passed since the previous analyses and the general agreement that pharmacists find themselves in an ideal position to offer adequate levels of counselling to headache patients, the knowledge of pharmacists is not yet sufficient. Clearly, there is a strong need to develop training programmes specifically focused on this subject. Regarding Italy, a national study, commenced in 2016, was designed as a cross-sectional survey employing face-to-face interviews between pharmacist and patient using a questionnaire drawn up by experts in compliance with best practice from scientific literature. Six hundred ten pharmacists followed a specific training course; 4425 questionnaires were correctly completed. The use of pharmacies as epidemiological sentinels, given their capillarity and daily contact with the local population in Italy, enabled us to obtain an epidemiological snapshot closer to the real-life situation compared to specialist headache centres. Over the course of this study, data on headaches were gathered in Italian pharmacies with the highest levels of numerosity in the world.
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Affiliation(s)
- Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy.
| | - Gianni Allais
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy.,FI.CEF. onlus, Italian Headache Foundation, via Celoria 11, 20133, Milan, Italy
| | - Sara Rolando
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | | | - Gennaro Bussone
- FI.CEF. onlus, Italian Headache Foundation, via Celoria 11, 20133, Milan, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Cecilia Scarinzi
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Teresa Spadea
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Giuseppe Costa
- Epidemiology Unit, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - Marco Parente
- Federfarma Torino, Via Sant'Anselmo, 14, 10125, Turin, Italy
| | - Massimo Mana
- Federfarma Piemonte, Via Sant'Anselmo, 14, 10125, Turin, Italy
| | - Mario Giaccone
- Order of Pharmacists of Turin, Via Sant'Anselmo, 14, 10125, Turin, Italy.,FOFI, Federation of the Orders of Italian Pharmacists, Via Palestro 75, 00185, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Via Palestro 75, 00185, Rome, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, 10125, Turin, Italy.,Order of Pharmacists of Turin, Via Sant'Anselmo, 14, 10125, Turin, Italy
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9
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Brusa P, Allais G, Scarinzi C, Baratta F, Parente M, Rolando S, Gnavi R, Spadea T, Costa G, Benedetto C, Mana M, Giaccone M, Mandelli A, Manzoni GC, Bussone G. Self-medication for migraine: A nationwide cross-sectional study in Italy. PLoS One 2019; 14:e0211191. [PMID: 30673780 PMCID: PMC6343913 DOI: 10.1371/journal.pone.0211191] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/08/2019] [Indexed: 01/03/2023] Open
Abstract
Headache disorders are considered the second leading cause of years lived with disability worldwide, and 90% of people have a headache episode at least once a year, thus representing a relevant public health priority. As the pharmacist is often the first and only point of reference for people complaining of headache, we carried out a survey in a nationwide sample of Italian pharmacies, in order to describe the distribution of migraine or non-migraine type headaches and medicines overuse among people entering pharmacies seeking for self-medication; and to evaluate the association, in particular of migraine, with socio-demographic and clinical characteristics, and with the pathway of care followed by the patients. A 14-item questionnaire, including socio-demographic and clinical factors, was administered by trained pharmacists to subjects who entered a pharmacy requesting self-medication for a headache attack. The ID Migraine™ Screener was used to classify headache sufferers in four classes. From June 2016 to January 2017, 4424 people have been interviewed. The prevalence of definite migraines was 40%, significantly higher among women and less educated people. About half of all headache sufferers and a third of migraineurs do not consider their condition as a disease and are not cared by any doctor. Among people seeking self-medication in pharmacies for acute headache attacks, the rate of definite or probable migraine is high, and a large percentage of them is not correctly diagnosed and treated. The pharmacy can be a valuable observatory for the study of headaches, and the first important step to improve the quality of care delivered to these patients.
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Affiliation(s)
- Paola Brusa
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
- Order of Pharmacists of Turin, Turin, Italy
- * E-mail:
| | - Gianni Allais
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
- FI.CEF Onlus, Italian Headache Foundation, Milan, Italy
| | | | - Francesca Baratta
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
| | - Marco Parente
- Department of Science and Technology of Drugs, University of Turin, Turin, Italy
| | - Sara Rolando
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | - Teresa Spadea
- Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy
| | | | - Chiara Benedetto
- Department of Surgical Sciences, Women’s Headache Center, University of Turin, Turin, Italy
| | | | - Mario Giaccone
- Order of Pharmacists of Turin, Turin, Italy
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
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10
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Micov A, Tomić M. The role of pharmacists in the management of certain common acute pain states. ARHIV ZA FARMACIJU 2019. [DOI: 10.5937/arhfarm1901015m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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11
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Van Driel ML, McGuire TM, Stark R, Lazure P, Garcia T, Sullivan L. Learnings and challenges to deploy an interprofessional and independent medical education programme to a new audience. J Eur CME 2018; 6:1400857. [PMID: 29644141 PMCID: PMC5843047 DOI: 10.1080/21614083.2017.1400857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/27/2017] [Indexed: 12/05/2022] Open
Abstract
The importance of interprofessional education (IPE) in continuing medical education and professional development has long been recognised by health organisations and academic societies, benefiting not only patient outcomes and interprofessional relationships but also overall health systems and workforce shortage. We report on the outcomes of an Australian IPE activity on medication-overuse headache (MOH) with general practitioners (GPs) and community pharmacists as learners. The design of the activity, which followed the predisposing–enabling–reinforcing instructional framework by Green and Kreuter, aimed to: (1) improve knowledge and foster a willingness in GPs and pharmacists to work collaboratively to enhance the prevention, diagnosis and management of MOH; and (2) address their educational gap by demonstrating the utility of a blended learning IPE strategy on MOH. Integrated into the activity was an assessment of its effectiveness and impact to instil change in the participants’ knowledge of MOH, attitude and willingness to treat, and clinical practice behaviours of GPs and pharmacists to work together. The learners gained knowledge and confidence in diagnosing and managing MOH and in their ability to educate patients. The IPE approach suited the activity and was valued by the participating GPs and pharmacists, who seldom experience such learning formats. However, for educational providers in Australia, developing and deploying an independent medical education (IME) programme can be challenging. Providers of IMEs need to be aware of the potential pitfalls when competing with pharmaceutical-company-sponsored and delivered programmes.
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Affiliation(s)
- Mieke L Van Driel
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Treasure M McGuire
- School of Pharmacy, University of Queensland, Brisbane, Australia.,Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia.,Mater Pharmacy Services, Mater Health Services, Brisbane, Australia
| | - Richard Stark
- Neurology Department, Alfred Hospital, Melbourne, Australia.,Department of Medicine, Monash University, Melbourne, Australia
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12
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Brusa P, Parente M, Allais G, Rolando S, Costa G, Gnavi R, Spadea T, Giaccone M, Mandelli A, Mana M, Baratta F, Benedetto C, Bussone G. Community pharmacies as epidemiological sentinels of headache: first experience in Italy. Neurol Sci 2018; 38:15-20. [PMID: 28527066 DOI: 10.1007/s10072-017-2908-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Migraine is a disabling neurovascular syndrome which affects 12-15% of the global population and it represents the third cause in years lived with disability in both males and females aged 15-49 years. Among migraineurs, the symptomatic drug abuse may be a risk factor in the development of medication overuse headache (MOH). Detecting cases of MOH is not straightforward; community pharmacists may, therefore, be in a strategic position to identify individuals who self-medicate, particularly with respect to prevent the development of MOH. In 2014, our group published the results of a survey conducted in Piedmont, Italy, on the patterns of use and dispensing of drugs in patients requesting assistance from pharmacists for relief of a migraine attack. We decided, now, to expand the scope of the model to a national level. The study is based on cross-sectional face-to-face interviews using questionnaires, presented in this paper, consisting of a first part regarding the socio-economic situation and a second part which aimed to classify the disease and any excessive use of drugs. Of the 610 pharmacists trained with an online course, 446 gathered a total of 4425 correctly compiled questionnaires. The participation of community pharmacies has highlighted various criticalities especially of an organisational nature; however, it also revealed the power of this method as a means of gathering epidemiological data with a capillarity which few other methods can match. The objective was also to identify each territory's requirements and facilitate the decision-making process in terms of understanding what patients/citizens actually require.
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Affiliation(s)
- Paola Brusa
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria n. 9, 10125, Turin, Italy. .,Order of Pharmacists of Turin, Turin, Italy.
| | - Marco Parente
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria n. 9, 10125, Turin, Italy
| | - Gianni Allais
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Turin, Italy.,FI.CEF Onlus, Milan, Italy
| | - Sara Rolando
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Turin, Italy
| | | | | | | | - Mario Giaccone
- Order of Pharmacists of Turin, Turin, Italy.,FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | - Andrea Mandelli
- FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy
| | - Massimo Mana
- ATF Informatics, Cuneo, Italy.,Federfarma Piemonte, Turin, Italy
| | - Francesca Baratta
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria n. 9, 10125, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Women's Headache Center, University of Turin, Turin, Italy
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13
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Sertel M, Şimşek TT, Yümin ET. The effect of body awareness therapy on pain and body image in patients with migraine and tension type headache. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2017. [DOI: 10.1080/17432979.2017.1371642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Sertel
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - T. T. Şimşek
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - E. T. Yümin
- School of Physical Therapy and Rehabilitation, Abant İzzet Baysal University, Bolu, Turkey
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14
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Gentile G, Chiossi L, Lionetto L, Martelletti P, Borro M. Pharmacogenetic insights into migraine treatment in children. Pharmacogenomics 2014; 15:1539-50. [DOI: 10.2217/pgs.14.104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Pediatric migraine is a disabling condition that can affect the everyday activities and emotional states of children. Due to the multifactorial character of the pathology and the variety of the disease's phenotypes, establishment of an effective treatment is often challenging. Pharmacological treatment is often administered off-label and includes very different drugs, from analgesics to antidepressants. Since interindividual variability in therapy response commonly causes inefficacy and an exacerbation of symptoms, pharmacogenetics may help to decrease the prescription rate of useless or unsafe drugs. If there are many drugs used in migraine, then there are even more candidate or established pharmacogenetic markers that are implicated in clinical profiles. This article presents the current situation regarding the pharmacogenetics of drugs used in pediatric migraine.
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Affiliation(s)
| | | | - Luana Lionetto
- Advanced Molecular Diagnostic Unit (DiMA), Sant’Andrea Hospital, Rome, Italy
| | - Paolo Martelletti
- Regional Referral Headache Center, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical & Molecular Medicine (DCMM), Sapienza University of Rome, Rome, Italy
| | - Marina Borro
- NESMOS Department, Sapienza University of Rome, Rome, Italy
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