Pilot study to improve health outcomes for medication-induced headache sufferers

The objectives of this prospective cohort study were to identify and encourage individuals with symptoms consistent with medication-induced headache (MIH) to seek medical help, and to determine the health outcomes of these patients. All community pharmacists (approximately 150) on Newfoundland's Avalon Peninsula were provided with continuing education material on MIH and were asked to display a poster inviting individuals taking analgesics more than two days a week for headache to speak to their pharmacist. Pharmacists were asked to provide a patient information pamphlet to individuals with medication use and symptoms consistent with MIH, to request them to contact a study nurse and to log the number of potential MIH patients encountered. The study nurse supervised the completion of headache and quality of life questionnaires, and advised the subjects to seek help from their family physicians. Forty-six pharmacists returned logs identifying 142 potential MIH subjects: 21 contacted the study nurse, 17 completed the questionnaires and 11 were classified as MIH sufferers. MIH sufferers reported a reduction in headache frequency (P<0.02) and analgesic consumption (P<0.05) when re-interviewed after three months. A health care team approach can improve health outcomes for some MIH sufferers. Further work to evaluate strategies to encourage chronic headache sufferers to seek help is required.