Migraine attacks in the pharmacy: a gender subanalysis on treatment preferences

Abstract

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. Epidemiological studies on migraine have consistently shown that migraine is far more common among women than men. This gender difference is also reflected in the higher percentage of women visiting a pharmacy to obtain treatment or advice for headache attacks. In this study, we further explored gender differences in healthcare-seeking behavior and use of migraine medications. The aim of the study was to determine whether women made better selective use of migraine medications and whether visiting a headache center for consultation and treatment reflected awareness of how best to manage their condition. Among the drugs usually taken for relieving head pain, there was no statistically significant difference between men and women in the routine use of NSAIDs (55.6 vs. 51.6 %) or ergot derivatives (8.7 vs. 9.3 %). Statistically significant differences emerged between men and women (27.9 vs. 35.4 %) in the use of triptans (p = 0.003; OR 1.41, 95 % CI 1.12-1.78) and in the use of combined medications (8.5 vs. 12.2 %) (p = 0.029; OR 1.49, 95 % CI 1.04-2.14) but not in the use of simple OTC non-NSAIDs. Less men than women sought professional medical care for managing migraine (65.7 vs. 72.4 %) (p = 0.003; OR 0.71, 95 % CI 0.57-0.89); more women than men sought treatment at a headache center (21.7 vs. 17.4 %) (p = 0.044; OR 1.31, 95 % CI 1.07-1.72).

Loss of Blood-Brain Barrier Integrity in a KCl-Induced Model of Episodic Headache Enhances CNS Drug Delivery

“…It is known, however, that migraine and many of the underlying disorders leading to secondary headache production afflict women more than men ( Hu et al, 1999 ; Haast et al, 2012 ). A higher percentage of women migraineurs are also reported to seek medical care, and use triptans, more often than men ( Brusa et al, 2015 ). Additionally, it has been suggested that women are more susceptible to secondary headache production in both traumatic brain injury and ischemic stroke compared to males ( Tentschert et al, 2005 ; Lucas et al, 2012 ).…”

Giving Researchers a Headache – Sex and Gender Differences in Migraine

“…Second, we excluded articles investigating the effects of migraine therapies and treatments to focus on sex-and gender-differences in migraine as a disease, itself, rather than sex-specific differences related to individual treatment strategies, adherence, and migraine management. We acknowledge there are important (behavioral) differences between males and females with respect to treatment, but these are outside the scope of the present review (102,120). Robbins and Bernat did not identify articles on treatment efficacy stratified by sex, illustrating that this topic also needs more attention in the field of migraine treatment research (121).…”

Pharmacist-led minor ailment programs: a Canadian perspective

“…These gaps are often created simply by patients choosing not to seek medical intervention, leading to suboptimal care. Gaps have been noted for allergic rhinitis, 48 migraine headaches, 49 allergic conjunctivitis, 50 , 51 acne, 52 and overactive bladder. 53 More allergy sufferers, for example, should be using topical intranasal steroids than the number that currently do.…”