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When a Headache Isn't Just a Headache:

Recognizing and Addressing Inequities in Migraine Care

Migraine disease affects roughly 1 in 4 households in the U.S., but the people most affected are often the least likely to be diagnosed or treated.

Community pharmacists see these patients every day.

We've developed free resources to help identify patients in need, start the conversation, and connect them to the care they deserve.

View the Infographic

View the Screening Tool

WATCH THE WEBINAR



The Disparity

Migraine prevalence is similar across racial and ethnic groups, but the disparities show up in who seeks care, who gets diagnosed, and who receives treatment

Even when patients seek care, they may face challenges such as limited access to specialists, lack of insurance coverage, and transportation barriers.

Additional factors include:

  • Historical bias in pain assessment
  • Medical mistrust rooted in historical harm
  • Misconceptions about who is affected
  • Underrepresentation of Black, Indigenous, and People of Color (BIPOC) patients in migraine research.

As part of our Migraine Equity Initiative, we have developed resources for community pharmacy professionals to help identify, engage, and refer those who may be living with undiagnosed or untreated migraine disease.


Resources for Community Pharmacy Professionals

SCREENING TOOL

This point-of-care tool puts everything you need in one place:

three quick screening questions, a clear decision rule for when to monitor versus refer, red flags that mean act now, and recommended language for talking to patients.

Favorite it as a quick reference and know exactly what to ask, what to watch for, and what to do next.

View and Share 

INFOGRAPHIC

A quick overview that lays out migraine disparities, myths, and shows where community pharmacists can help close the gap. 

It also includes a language guide to help pharmacists speak about migraine the right way. 

Share it with your team, or use it to start a conversation. The resources are useful for staff training or for sparking a conversation in your pharmacy.

View and Share


Why This Matters for Pharmacists

Community pharmacists are often the most consistent healthcare touchpoint.

People may go months or years between doctor visits, but they refill prescriptions, pick up OTC remedies, and ask quick questions at the pharmacy counter, sometimes monthly or more.

That regular contact creates the chance to notice patterns, ask questions that haven't been asked before, and point patients in the right direction.




Who You Might See

These common patient presentations may signal a missed diagnosis.

1. THE FREQUENT OTC PURCHASER 


She buys OTC pain relievers every few weeks and rarely asks questions. Repeated purchases may signal recurring migraine attacks, medication overuse, or progression toward chronic migraine disease.

ASK: How often are you experiencing headaches, and how often do you need to take medication to manage them?

2. “I JUST LIVE WITH IT."


He misses events, avoids bright environments, and rests in dark rooms. His symptoms have been normalized for so long that neither he nor those around him recognize them as a treatable condition.

ASK: “Do your headaches prevent you from doing the things you need or want to do?”

3. THE PATIENT NOBODY ASKED


She has had severe headaches for years with no migraine diagnosis. Past healthcare encounters focused on managing symptoms, not identifying the underlying condition. She continues to self-manage with no treatment plan.

ASK: “Has a healthcare professional ever talked with you about whether these headaches might be migraine disease?”


Talking to Patients About Migraine

1. NOTICE THE PATTERN

"I see you've been picking up pain relievers pretty often. Are headaches affecting your daily life?"



2. NAME IT CLEARLY

"What you're describing sounds like it could be migraine disease, not just a headache. There are prescription treatments that may help, both to manage attacks and prevent them.

3. MAKE THE REFERRAL

"I'd recommend bringing this up with your doctor at your next appointment. Would it help to know what to say when you go?"


Thank you to our Expert Contributors

Ruth Adeyemi, PharmD, MPH | Founder, SARMLife Limited


Andrew Clark, PharmD | Owner, Northtown Pharmacy


Gabrielle Dorsey | Founder and Principal, NICH TCA

Chandler Fullington, PharmD | Health Policy and Association Leadership (HPAL) Executive Fellowship, NPhA and ASCP

Ogechi Ubanyionwu, PharmD, BCACP | Clinical Ambulatory CarePharmacist, Harris Health

Shantel Upshaw Houston, PharmD | Interim Executive Vice President, NPhA



Pfizer logo in transparent PNG and vectorized SVG formats

This resource was developed by the National Pharmaceutical Association (NPhA) with support from Pfizer. 

It does not constitute clinical advice.

Learn more about Pfizer here





OUR MISSION

The National Pharmaceutical Association is dedicated to representing the views and ideals of minority pharmacists on critical issues affecting healthcare and pharmacy, promoting racial and health equity, as well as advancing the standards of pharmaceutical care among all practitioners.

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