Side effects sidetrack migraine Rx compliance

Pharmacists should be aware that their patients’ prescribed medication for migraine headaches may have a compliance problem, according to the results of a survey by the National Headache Foundation (NHF).

The foundation’s survey of 1,160 migraine patients found that 62% of them experienced side effects from their anti-migraine medications, and two out of three delayed taking the drugs, or skipped doses altogether due to concerns about such side effects. The upshot for these patients is more severe and prolonged pain, as well as increased disability.

The most bothersome medication side effects reported were nausea and sleepiness, according to the survey underwritten by a grant from Pharmacia Corp. Concern about side effects is one of the top reasons people don’t fill their scripts. It’s also the main reason they switch medications and follow treatment recommendations. Nearly 25% said they use over-the-counter remedies instead of prescription drug products to avoid side effects; but half the time, such products didn’t give satisfactory results.

Patients reported that during the previous six months they had delayed doses for more than 37% of their treated headaches and avoided medications altogether for 52% of the attacks. This pattern of noncompliance resulted in more intense pain, according to 60% of those surveyed; 59% said they needed to lie down or had longer duration of pain; 26% cancelled social activities; 25% said their job or school performance suffered; and 21% said they missed work.

"Successful migraine management remains a challenge," said Suzanne Simons, NHF executive director. "Studies like this one are helping us to learn more about the impact of migraine so we can take active steps to improve care and overall satisfaction for sufferers."

Carol Ukens