Counseling practices and headache management indicate the need for training and education of pharmacists in an Ethiopian city to better serve individuals with headache complaints, according to a study published in The Journal of Headache and Pain.

This dual-phase mixed-methods study was conducted to assess the counseling abilities and headache management practices provided at community medicine retail outlets (pharmacies, drug stores, and drug vendors) in the city of Gondar, Ethiopia. In the first phase, a pseudo-patient presented with intermittent headache at 1 of 60 community medicine retail outlets. In the second phase, 1 staff member at each outlet was asked to complete a questionnaire regarding drug dispensing experiences, headache management practices, and other elements.

Of the pharmacists visited by a pseudo-patient, 95% prescribed medication for headache, and the remaining 5% suggested the client consult a physician to identify potential causes. In addition, 42.6% of pharmacists provided patients with counseling, and this rate increased to 58.3% when patients demanded further information. Pharmacists (73.3%) asked patients about the duration of their headache prior to prescribing generic medicine such as ibuprofen and diclofenac, and 45% asked about signs and symptoms. The most common reasons given to patients for choosing specific drugs were effectiveness (61.7%) and cost (21.7%). 

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Furthermore, 86.7% of pharmacists discussed dosing frequency, 60% discussed indication, and 35% discussed dosage form. Outlets were rated on overall professional counseling approach using a 5-point scale, (1 indicating poor counseling and 5, excellent counseling). The average score was 2.14, with only 42.6% of outlets providing adequate counseling. Of the 51 representatives who agreed to participate in the follow-up survey, 64.7% agreed that managing headache symptomatically is a difficult process, 41.2% reported patient lack of confidence in drug dispensers as a primary barrier to proper counseling, and 31.4% blamed a lack of updated medical information.

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The researchers noted certain limitations of their study, including an inability to generalize findings to other regions in the country or globally.

”Providing continuous clinical training and educational interventions are needed in order to mitigate the knowledge and skill gap,” noted the study authors.

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Netere AK, Erku DA, Sendekie AK, Gebreyohannes EA, Muluneh NY, Belachew SA. Assessment of community pharmacy professionals’ knowledge and counseling skills achievement towards headache management: a cross-sectional and simulated-client based mixed study. J Headache Pain. 2018;19:96.