• Charly Gaul, Heidemarie Gräter, and Thomas Weiser.
• Migraine and Headache Clinic Königstein, Ölmühlweg 31, 61462 Königstein im Taunus, Germany.
• Springerplus. 2016 Jan 1; 5 (1): 721.

BackgroundPatients suffering from migraine or tension-type headache (TTH) often treat their complaints with over-the-counter (OTC) medications. Fixed dose combinations of acetylsalicylic acid, paracetamol and caffeine (APC) are among the most commonly used analgesics, and their efficacy for treating acute headache pain has been well demonstrated. This investigation was run to better characterize patients who treat their headache with OTC APC combinations, as well as treatment effects.MethodsA pharmacy-based patient survey in 164 German pharmacies was performed. Patients (age ≥18 years) who purchased APC analgesics (of the brand Thomapyrin(®)) were handed a questionnaire, which had to be filled out at patients own discretion after taking the medication. Demographics, pain characteristics and perceived efficacy and tolerability data were analysed with descriptive statistics.ResultsQuestionnaires from 1298 patients were analysed, of whom 71.9 % were females and 28.1 % were males. Headache patients were assigned to TTH or migraine according to diagnosis criteria of the International Headache Classification-II (ICHD-II), with 828 patients for TTH and 206 for migraine. About one third of patients in the subgroup migraine did not report their pain as migraine. Nausea, photophobia/phonophobia turned out to be the most distinguishing feature between migraine and TTH. The main reasons for purchasing the product were recommendation by the pharmacists (40.5 %) and/or friends or relatives (24.4 %). 74 % of TTH and 55 % of migraine patients reported onset of pain relief within the first 30 min. More than 90 % rated efficacy as well as tolerability to be "good" or "very good".ConclusionsThe main reason for purchasing APC products in the pharmacy are TTH or migraine. About a third of patients fulfilling the IHCD-II criteria for migraine failed to recognize their headache as migraine. This could be explained e.g. by patients' misconceptions about their pain. Patients' assessments of efficacy and tolerability showed that the investigated APC combinations are valuable for the treatment of TTH and migraine headache. These data complement those of randomized clinical studies on such preparations.

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