Hoffmann Wolfgang, Herzog Beatrice, Mühlig Stephan, Kayser Hubertus, Fabian Rüdiger, Thomsen Martin, Cramer Michael, Fiss Thomas, Gresselmeyer Doris, Janhsen Katrin
Institute of Community Medicine, University of Greifswald, Greifswald, Germany.
Ann Pharmacother. 2008 Dec;42(12):1804-13. doi: 10.1345/aph.1K635. Epub 2008 Nov 11.
BACKGROUND: Despite the high prevalence of headache and migraine in the general population, many people do not receive adequate medical attention and treatment. OBJECTIVE: To evaluate the effects of pharmaceutical care (defined as intensified structured counseling between patient and pharmacist, including the use of drug databases), for patients with headache or migraine, on both clinical and psychological endpoints. METHODS: A prospective, randomized, controlled intervention study was conducted using pharmacies in Northern Germany. A total of 112 pharmacies (26% of all pharmacies in the study region) recruited 410 patients with headaches. Pharmacies were randomly assigned to an intervention or control group. Patients were interviewed by telephone prior to the intervention and again after 4 months. Primary endpoints were number of days with headache, number and severity of headaches, self-efficacy, and the patients' perceptions of their health-related quality of life. RESULTS: Each pharmacy treated an average of 4.6 patients (total time effort 9 h). The intervention group consisted of 201 patients who received pharmaceutical care, whereas the control group comprised 209 patients who received standard counseling. In both groups, the number of headache attacks and intensity of pain in treated headache attacks did not change significantly between the first and second interviews. However, a statistically significant improvement in mental health and self-efficacy was shown in the intervention group. Intensity of pain in untreated headache attacks and the number of days with headache decreased in both groups. Most participants described this intervention as helpful and effective and 90% reported that they would recommend pharmaceutical care to other patients with headache. CONCLUSIONS: A short-term pharmaceutical care intervention improved patients' mental health and self-efficacy, although it did not significantly change the number and severity of headaches. The increase in self-efficacy and mental health associated with pharmaceutical care may be instrumental in improving long-term pharmacotherapy of patients with migraine and headache. To fully assess the effects of pharmaceutical care, a longer study may be required.
背景：尽管头痛和偏头痛在普通人群中患病率很高，但许多人并未得到充分的医疗关注和治疗。 目的：评估药学服务（定义为患者与药剂师之间强化的结构化咨询，包括使用药物数据库）对头痛或偏头痛患者临床和心理结局的影响。 方法：在德国北部的药房进行了一项前瞻性、随机、对照干预研究。共有112家药房（占研究区域所有药房的26%）招募了410名头痛患者。药房被随机分配到干预组或对照组。在干预前和4个月后通过电话对患者进行访谈。主要结局指标为头痛天数、头痛次数和严重程度、自我效能感以及患者对其健康相关生活质量的认知。 结果：每家药房平均治疗4.6名患者（总时间投入9小时）。干预组由201名接受药学服务的患者组成，而对照组由209名接受标准咨询的患者组成。在两组中，首次和第二次访谈之间，治疗的头痛发作次数和疼痛强度均无显著变化。然而，干预组在心理健康和自我效能感方面显示出统计学上的显著改善。两组中未治疗的头痛发作疼痛强度和头痛天数均有所减少。大多数参与者认为这种干预有帮助且有效，90%的人报告他们会向其他头痛患者推荐药学服务。 结论：短期药学服务干预改善了患者的心理健康和自我效能感，尽管它并未显著改变头痛的次数和严重程度。与药学服务相关的自我效能感和心理健康的提高可能有助于改善偏头痛和头痛患者的长期药物治疗。为了全面评估药学服务的效果，可能需要进行更长时间的研究。
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