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Resident Perceptions of Migraine Management and Interventions to Improve Care

Journal: American Journal of Health-System Pharmacy Date: 2025/01, 82(S1):Pages: S2543. doi: Subito , type of study: cross sectional study

Full text    (https://academic.oup.com/ajhp/article/82/Supplement_1/S1/7945688)

Keywords:

cross sectional study [821]
migraine [68]
osteopathic medicine [2010]
perception [128]
residents [9]
USA [1610]

Abstract:

Purpose: The World Health Organization placed migraine as one of the 10 most disabling medical illnesses worldwide. According to the American Migraine Foundation, fewer than 5% of those with migraines have been seen by a healthcare provider and received an accurate diagnosis. This survey aimed to understand healthcare professionals clinical decision-making when considering migraine diagnosis in an internal medicine resident clinic at a community teaching hospital. The purpose of this study was to use survey results to provide direction for targeted healthcare professional education, focusing on methods of reducing barriers to migraine care including medication expenses and access to patient-education resources. Methods: An anonymous research survey was created and distributed to medical residents at a community teaching hospital. Surveys were completed voluntarily and returned to the clinical pharmacist. Results were collected for 5 months, from February to July 2024. IRB approval was completed in July 2024. Survey results were included if all areas of the survey were entirely completed upon submission. The primary outcome included determining the most prescribed migraine medications. The secondary outcomes included residents access to migraine medication pricing, monitoring parameters, and patient education resources. Results: A total of 16 residents completed surveys, including six medical doctors (MDs) and 10 doctors of osteopathic medicine (DOs), further broken down to seven first-year residents, five second-year residents, and four third-year residents. The most prescribed acute medications included triptans (88%) and non-opioid analgesics (88%). The most commonly prescribed preventative medications included antidepressants (69%) and antihypertensives (63%). One hundred percent of residents did not have an information cost resource for migraine medications. Twelve residents (75%) did not have a tool to evaluate the safety of migraine pharmacotherapy. A majority (63%) did not have a resource for appropriate migraine patient education. Eighty-six percent of residents indicated that patient handouts with general migraine information would be a beneficial resource. Conclusion: Survey responses indicated residents tend to prescribe non-opioid analgesics and triptans for acute migraine care, while giving preference to antidepressants and antihypertensives for preventative care. The most significant barriers to patient care included limited knowledge about the efficacy, safety, and tolerability of migraine pharmacotherapy. Findings also suggested residents could benefit from having migraine patient education and medication cost resources. A strength of this study is the wide array of outcomes that were assessed, which included diagnostic parameters and cost considerations. The results of this survey may be applied to improve migraine diagnosis, treatment, and prevention .


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