Donnet Anne, Lantéri-Minet Michel, Aucoin François, Allaf Bashar
Department of Neurology, Clinical Neuroscience Federation, La Timone Hospital, 264, boulevard Saint-Pierre, 13385 Marseille cedex, France.
Headache. 2009 Jul;49(7):1014-21. doi: 10.1111/j.1526-4610.2009.01395.x. Epub 2009 Mar 26.
Pharmacy personnel are supposed to be well informed of recommendations for proper migraine management, but their easy access to medicines may favor self-medication and promote medication overuse for those with frequent migraine attacks.
The main objective of the COTA survey was to investigate migraine management by pharmacy personnel who considered themselves as migraineurs.
Out of 22,000 pharmacies currently open in France, a questionnaire was proposed to a random sample of approximately 4000 pharmacies with at least 1 self-considered migraineur in the pharmacy staff who accepted to complete and return the questionnaire. The reality of migraine was assessed by the study questionnaire according to the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria. In addition, the study questionnaire inquired about subjects' demographics, headache characteristics, consumption of medications for headaches, subjects' satisfaction with the usual treatment of headaches and treatment effectiveness. Medication overuse was defined in terms of treatment days per month during the previous 3 months according to the ICHD-II criteria for medication overuse headache.
Some 74% of the 3326 participating pharmacies with a self-considered migraine subject among their staff actually returned the survey questionnaire. Using the ICHD-II criteria, migraine was confirmed in 85% of participating subjects, of whom 38% were under medical supervision and had asked for a prescription, and 27% used recommended medications. The treatment used was truly effective for only 31% of migraineurs. Medication overuse was observed in 21% of all participating subjects, mostly migraineurs. Most migraineurs with medication overuse (81%) used nonrecommended treatments.
Considering their pivotal role in advising migraine patients who seek their help with self-management, migraine education of pharmacy personnel about proper migraine management should be reinforced.
药剂人员理应熟知偏头痛合理管理的相关建议，但他们能轻易获取药品，这可能会助长自我药疗行为，并促使频繁偏头痛发作的患者过度用药。
COTA调查的主要目的是研究自认为是偏头痛患者的药剂人员对偏头痛的管理情况。
在法国目前营业的22000家药店中，向约4000家药店的随机样本发放问卷，这些药店的员工中至少有1名自认为是偏头痛患者且同意填写并返还问卷。根据《国际头痛疾病分类》第二版（ICHD-II）标准，通过研究问卷评估偏头痛的实际情况。此外，研究问卷还询问了受试者的人口统计学特征、头痛特点、头痛用药情况、受试者对头痛常规治疗的满意度以及治疗效果。根据ICHD-II中药物过量使用性头痛的标准，通过前3个月每月的治疗天数来定义药物过量使用。
在3326家员工中有自认为是偏头痛患者的参与调查药店中，约74%实际返还了调查问卷。根据ICHD-II标准，85%的参与调查受试者被确诊为偏头痛，其中38%接受医疗监督并已开具处方，27%使用推荐药物。所用治疗方法仅对31%的偏头痛患者真正有效。在所有参与调查的受试者中，21%存在药物过量使用情况，其中大多数是偏头痛患者。大多数药物过量使用的偏头痛患者（81%）使用了非推荐治疗方法。
鉴于药剂人员在为寻求自我管理帮助的偏头痛患者提供建议方面的关键作用，应加强对他们进行偏头痛合理管理方面的教育。
