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PLoS One. 2019 Jan 23;14(1):e0211191. doi: 10.1371/journal.pone.0211191. eCollection 2019.

Self-medication for migraine: A nationwide cross-sectional study in Italy.

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Department of Science and Technology of Drugs, University of Turin, Turin, Italy.
Order of Pharmacists of Turin, Turin, Italy.
Department of Surgical Sciences, Women's Headache Center, University of Turin, Turin, Italy.
FI.CEF Onlus, Italian Headache Foundation, Milan, Italy.
Epidemiology Unit, ASL TO3, Grugliasco (Turin), Italy.
ATF Informatics, Cuneo, Italy.
FOFI, Federation of the Orders of Italian Pharmacists, Rome, Italy.


Headache disorders are considered the second leading cause of years lived with disability worldwide, and 90% of people have a headache episode at least once a year, thus representing a relevant public health priority. As the pharmacist is often the first and only point of reference for people complaining of headache, we carried out a survey in a nationwide sample of Italian pharmacies, in order to describe the distribution of migraine or non-migraine type headaches and medicines overuse among people entering pharmacies seeking for self-medication; and to evaluate the association, in particular of migraine, with socio-demographic and clinical characteristics, and with the pathway of care followed by the patients. A 14-item questionnaire, including socio-demographic and clinical factors, was administered by trained pharmacists to subjects who entered a pharmacy requesting self-medication for a headache attack. The ID Migraineā„¢ Screener was used to classify headache sufferers in four classes. From June 2016 to January 2017, 4424 people have been interviewed. The prevalence of definite migraines was 40%, significantly higher among women and less educated people. About half of all headache sufferers and a third of migraineurs do not consider their condition as a disease and are not cared by any doctor. Among people seeking self-medication in pharmacies for acute headache attacks, the rate of definite or probable migraine is high, and a large percentage of them is not correctly diagnosed and treated. The pharmacy can be a valuable observatory for the study of headaches, and the first important step to improve the quality of care delivered to these patients.

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