(1240) The Impact of Targeted Medication Review by Community Pharmacists on the Prescription of Migraine Preventive Therapy in Two Locations of a Large Community Pharmacy Chain

Objectives: The primary objective of this study is to determine the impact of a targeted medication review by a community pharmacist on increasing the number of patients prescribed migraine preventive therapy (MPT). Secondary objectives include (1) To report the number of patients receiving MPT for the first time after pharmacist contact and (2) To identify patient-specific barriers to receiving a MPT prescription. Migraine disorder affects around 10% of the global population. MPT is often underutilized as it is estimated that about 40% of patients who suffer from migraines could benefit from it, yet as few as 3-13% of patients receive it. Community pharmacist involvement in MPT initiation has not directly been studied, but community pharmacists may be in an ideal position to help close this gap in therapy given their accessibility and trustworthiness to the public and their medication expertise.

Methods: This will be a prospective randomized controlled trial taking place in two comparable locations of a large community pharmacy chain from October 2023 to February 2024. Randomization into the intervention or standard of care group will occur at the pharmacy-level. Internal pharmacy reports will be utilized to identify patients who may qualify for MPT based on fill history of a pre-defined migraine abortive medication and absence of a MPT prescription fill within the past 6 months. Patients must be at least 18 years old, must fill prescriptions within the selected pharmacies, and must not be actively taking MPT to be included in the study. In both arms, if the patient has filled a migraine abortive medication and is not receiving MPT based on profile review, they will be contacted via phone and their eligibility for MPT, current and past use of MPT, preferences, and barriers to prescription of MPT will be assessed using a standardized questionnaire which includes a validated migraine assessment tool. Additionally, all patients will receive education on MPT.
Only patients in the intervention group will receive an offer to contact their provider on their behalf with a strong recommendation for MPT in addition to scheduled follow-up throughout the process of obtaining a prescription for MPT. In the standard of care group, instead of the pharmacist outreaching the provider for the patient, patients will be encouraged to follow up with their provider themselves about obtaining MPT if appropriate. Profile review throughout the implementation period will allow us to track the number of patients who have been prescribed and have filled MPT. The questionnaire will allow us to report the number of patients receiving MPT for the first time after pharmacist contact and to characterize the barriers to receipt of a prescription for MPT. The primary objective will be analyzed using a Chi-square test, and the secondary objectives will be reported using descriptive statistics. To maintain intervention fidelity, store-assigned pharmacists at the study sites will receive training on how to conduct the intervention and will be provided with guidance for making a recommendation for MPT. If a potential MPT candidate returns a call when an untrained pharmacist is working, they will be instructed to document the call and defer until a trained pharmacist can conduct the patient interview.

Results: Research is in progress. Results will be reported at the 2024 APhA Annual Meeting and Exposition.

Conclusions: This study seeks to determine the feasibility and impact of pharmacist involvement in MPT initiation in the community pharmacy setting, and to further characterize barriers to prescription of MPT.