New Migraine Toolkit Helps Pharmacists Tackle Racial Care Gaps

The National Pharmaceutical Association (NPhA), with support from Pfizer, has launched a new migraine toolkit aimed at helping community pharmacists address long-standing racial disparities in headache care, particularly for Black patients who are frequently underdiagnosed and undertreated.

“The toolkit was actually launched by the National Pharmaceutical Association, or NPhA, and this was actually supported by Pfizer,” Ogechi Ubanyionwu, PharmD, BCACP, clinical pharmacy specialist of ambulatory care at the Harris Health System, said. “Basically, this aim to reduce racial disparities, especially as it relates to migraine recognition and treatment among underserved patients, especially in our African American adults who experience higher disease burdens yet remain significantly underdiagnosed and underrepresented.”

The toolkit is live and available digitally through NPhA. “The toolkit is actually currently live, and it's available digitally on our website on the NPhA website,” Ubanyionwu explained. “So this can be found on https://www.npha.net/migraine. Basically, serving as a centralized digital resource hub. There's currently housed an educational infographic as well as a screening tool for community pharmacists.”

The resource was launched in connection with Migraine and Headache Awareness Month, held annually in June, to help build public understanding of migraine as a serious neurologic disorder rather than “just a headache.” Ubanyionwu noted that the initiative is meant to both educate and destigmatize. The toolkit, she said, “was actually launched in anticipation of the Migraine and Headache Awareness Month, which is usually annually every June, to educate the public, basically reducing any social stigmas as well as highlighting the severe personal and professional impact of neurological headache disorders.”

Black patients are less likely to be accurately diagnosed and treated for migraine despite comparable or higher disease burden.

“Disparities are definitely showing up, especially in those who seek care, as well as those who get diagnosed and who also receive treatment,” Ubanyionwu said. “This is especially seen in our Black communities, unfortunately, due to some systemic barriers, and this can be migraine definitely going undiagnosed due to some of the historical biases, especially as it relates to pain assessment, medical mistrust, and then of course, having limited access to neurologists and headache specialists, and then there's also the underrepresentation as it relates to research in Black and Indigenous and people of color.”

The migraine toolkit positions community pharmacists as frontline identifiers of potential migraine cases.

“Community pharmacists, especially community pharmacy professionals, we're actually uniquely positioned to help address some of these barriers by utilizing toolkits as these, just basically recognizing and screening individuals in the community to start having those necessary conversations and also refer patients who need those diagnoses and/or prescription therapy,” she said.

The toolkit outlines three key patient groups pharmacists should watch for. “These are essentially the patients that we want to look out for,” Ubanyionwu said. “These are one of our frequent over-the-counter purchasers. These are individuals that we are identifying in the community that are repeat purchasers of our analgesics. This can help in signaling us to people who may have those reoccurring migraine attacks or early progression to chronic migraine disease.”

The second group includes people who have adapted their lives around symptoms.

“The second one is just identifying the patients who has those adaptive symptoms,” she said. “These are individuals who are avoiding bright-light environments, right? They're missing events. They're resting in those dark rooms. These are symptoms that they may have normalized for so long and can sometimes be unrecognized.”

Finally, pharmacists are urged to engage patients who have endured severe headaches without ever being evaluated for migraine. “Thirdly, the patients who have never been asked,” Ubanyionwu added. “So these are patients who have years of severe headache [and] no migraine diagnosis. So prior care focuses mainly on their symptoms, but not necessarily their underlying conditions.”

Ubanyionwu emphasized that the toolkit is built specifically for community pharmacy practice.

“This was a toolkit that was designed with community pharmacists in mind and are in the forefront to be able to identify these types of behaviors or at least establish a rapport where they're able to have these types of conversations with these individuals in the community setting,” Ubanyionwu said.