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PHARMACy PRACTiCE TRAiNiNG
Migraine is common neurological disorder1 that represents a real burden
2,3 Unfortunately, while many have explored the impact of
migraine, there is still more to be done to improve the management
of this condition, despite there being various treatments available.
Pharmacists can play a very important role in providing relief and support
for these patients.
It is widely accepted that migraines
are common, underdiagnosed and
countries the prevalence is
approximately 1 in 102 and worldwide
migraine ranked as the third most
The primary symptom of a migraine is
headache; however migraine is more
than just a headache.
It represents a
real burden to sufferers. Indeed, the
Global Burden of Disease Study (2010),
places migraine in the top 10 causes of
disability in many regions of the world3
and the World Health Organisation
(WHO) estimates that a day with a severe
migraine is as disabling as a day as a
It has also been found that
treatment is inadequate2,3 and roughly
half of migraineurs are incorrectly
Furthermore, only half
of all patients will see a healthcare
professional about their headache.2,4
What are the barriers to
treatment of Migraine?
The number of patients seeking advice
from pharmacists about management
of migraine symptoms is low, especially
when the prevalence of migraine is
There are several barriers
that are thought to be causing this.
The first reason is a lack of awareness
in the community about migraine.6
The second is confusion among
healthcare professionals about the
definition of a migraine compared with
other headache types.2,4
affected pharmacy customers are
requesting pain relief by brand and
thus are missing the opportunity
to be questioned about the type of
headache they are experiencing and
then appropriately counselled about
What is the pharmacist’s role
in treating migraine?
The earlier the treatment is initiated
Pharmacists can play a very
important role in improving patient
outcomes through pharmacological
and non-pharmacological treatment
recommendations (such as bed rest
in quiet, darkened room or avoiding
movement or any activity, including
reading or watching television) and
The reason for this
that pharmacists are a very accessible
healthcare professional and so have the
opportunity to interact with diagnosed
and undiagnosed migraineurs.
Tools available to pharmacists
to help treat migraine
OTC analgesics like paracetamol, aspirin
and ibuprofen, have been shown to
have a clinical benefit in relieving the
pain of migraine.6,7
is often accompanied by nausea and/or
vomiting, which can significantly hinder
its management as patients may delay
taking their oral treatments.
treatment of the nausea associated with
migraine (when it presents) is critical
for effective management of migraine.
In Australia, there are two Pharmacist-only
preparations available for the treatment
of nausea associated with migraine;
paracetamol and metoclopramide in
combination and prochlorperazine alone.9,10
1. international headache society (ihs). Cephalalgia, 2013,33:
2. world health organisation (who) and lifting the burden. 2011.
3. steiner, t, stovner, l and birbeck, g. 1, the Journal of
headache and pain, 2013: 14.
4. murray, Ka, skomo, ml and Carter, sm, innovations in
5. harwood rh, sayer aa and hirschfeld m. 4, s.l. : bulletin world
health organisation, 2004: 82.
6. rutter and newby. elsevier australia, 2012
7. lainez, garcia-Casado, gascon. patient related outcome
measures, 2013: 4
8. newman, lC. headache 2013;53;s1:11-16.
9. anagraine product information. Jan 2005. 10. nausetil product
information. may 2010
all sales and marketing requests to
Aspen Pharmacare Pty Ltd
34–36 Chandos street
st leonards, nsw 2065
P: +61 2 8436 8300
Migraine with nausea
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