Impact of Changing Migraine Outcome on Pharmacist Interventions in a Health-System Specialty Pharmacy

Health-system specialty pharmacies (HSSPs) provide specialized medication therapy management to patients with complex medical conditions. HSSPs assess clinical outcomes for specialty disease states, including migraines. There are currently no studies comparing types of outcomes for patients with migraines and the impact on pharmacist intervention in HSSPs. The aim of this study was to determine if changing migraine outcome from a non-disease specific patient reported outcome measure (PROM) to a disease specific patient reported outcome (PRO) impacts the number of pharmacist interventions made on migraine regimens in a HSSP. A single-center, pre-post, retrospective chart review was conducted at a HSSP. Adult patients who received at least one abortive specialty migraine medication and/or at least three preventative specialty migraine medication fills were included in the study. The primary endpoint was the number of pharmacist interventions regarding pharmacologic migraine regimens before and after the outcome change. Key secondary endpoints included change in number of migraine days per month, change in number of missed days from school, work or planned activities, number of migraine episodes requiring hospitalization, and overall number of pharmacist interventions. There were 61 patients included in the study. The number of pharmacist interventions on migraine regimens was no difference between the migraine PROs group (15.2%) when compared to the PROM group (13.5%; P = 0.715). Utilizing either non-disease specific PROM or disease-specific PROs as a clinical outcome measure for HSSP migraine patients could be valuable, with the latter shifting pharmacist interventions toward migraine pharmacotherapy optimization.