Original Research
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction: Headache is a common symptom following traumatic brain injury (TBI). Over half of patients develop headache within 7 days of mild TBI, and a significant number of patients develop delayed onset post-traumatic headache. This analysis intended to identify the types of headache treatments involved in pharmacy interventions in a post-TBI clinic.
Research Question or Hypothesis: We hypothesized that most headache treatment interventions involved abortive therapies.
Study Design: This analysis was an IRB-approved retrospective chart review of pharmacy interventions in the Brain Injury Center (BIC) clinic at a level one trauma center.
Methods: Patients who received clinical pharmacy services in BIC clinic between January 2020 and August 2022 were identified by a documented pharmacy intervention and associated note by the BIC clinical pharmacist. The chart note was reviewed for interventions involving headache treatments. The primary outcome was the type of headache treatment involved in pharmacist intervention.
Results: Pharmacy services were documented with a total of 461 BIC visits (399 patients). Of these BIC visits, 101 involved a headache-related intervention (85 patients). The median age of patients with headache-related interventions was 45 (IQR 37-58) years, median GCS at hospital discharge was 15 (IQR 15-15), and median time from injury to BIC appointment was 91 (IQR 51-127) days. New or escalating headache therapy occurred in 57% of identified visits. All visits included counseling regarding one or more headache treatments. Headache interventions involved abortive therapy (51%), preventative therapy (30%), and a combination of both (18%). Interventions involved prescription medications (49%), OTC treatments (38%), and both prescription and OTC medications (13%). Medication over-use headache required intervention in 21% of visits. Headache interventions involved a variety of drug classes, including analgesics (46%), NSAIDs (25%), antidepressants (18%), and beta-blockers (10%).
Conclusion: Over 20% of BIC clinic visits involved one or more headache-related interventions. Most headache-related interventions involved abortive treatments, and prescription medications were commonly required.
Presenting Author
Susan Hamblin PharmD, BCCCP, FCCMLipscomb University College of Pharmacy
Authors
Leanne Atchison Pharm.D.
Vanderbilt University Medical Center
Jennifer Beavers Pharm.D., BCPS
Vanderbilt University Medical Center
Edward Woo Jr. PharmD
Vanderbilt University Medical Center