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Migraine Masters: Part II: Pharmacology - a vClinic.org program

Neurology
Curriculum:
Modern Migraine Management
Credits:
1.5 ANCC Contact Hours 1.5 AMA PRA Category 1 Credit(s)™
Launch Date:
June 09, 2016
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Physicians, PAs, NPs, and Nurses and other healthcare professionals involved in the treatment of migraine headaches

Relevant Terms:

Migraine, Headache, Chronic Pain

Stephen Landy, MD

Stephen Landy, MD
Clinical Professor of Neurology
University of Tennessee Medical School 
Memphis, TN

Dr. Landy is board-certified in both neurology and headache medicine and has been in practice for 33 years. He is a Clinical Professor of Neurology at the University of Tennessee Medical School and is affiliated with the Baptist Memorial Hospital-Memphis. He received his medical degree from the University of Tennessee College of Medicine and completed his residency at Vanderbilt University Medical Center.
 
Dr. Landy has authored nearly 100 publications on the subject of headache and migraine headaches over the past 20 years.

Brian D. Loftus, MD

Brian D. Loftus, MD
Director, Bellaire Neurology
President, Southern Headache Society
Houston, TX

Brian D. Loftus, MD, is a private practice neurologist at Bellaire Neurology in Houston, Texas. He is Chief Medical Officer at BetterQOL.com, the developer of iHeadache family of products. iHeadache app (iOS app store), iHeadache Online (iHeadache.com) and iHeadache MD (iHeadacheMD.com) represents the most advanced and most widely used electronic headache diary system.

Board Certified in Neurology and Headache Medicine, Dr. Loftus has been the principal investigator for a number of clinical trials.  His research has focused primarily on patients with migraine headaches, neuropathic pain, and multiple sclerosis.

Dr. Loftus is President of the Southern Headache Society, a member of the Comprehensive Care Committee of the National Multiple Sclerosis Society and a member of the Healthcare Advisory Committee of the National Multiple Sclerosis Society's South Central Region.

Rebecca Burch, MD

Rebecca Burch, MD
Instructor, Harvard Medical School
Director, Outpatient Infusion Program,
John R. Graham Headache Center
Brigham and Women's Faulkner Hospitals 
Boston, MA

Dr. Burch is a headache medicine specialist at the John R. Graham Headache Center, and is also the director of the Center's Outpatient Infusion Program. She also provides care in headache medicine at the BWH Ambulatory Center in Chestnut Hill.
 
Dr. Burch received an MD from the University of Massachusetts Medical School and completed her Neurology residency at Boston Medical Center. She completed a fellowship in Headache Medicine at Harvard Medical School, Brigham and Women's/Faulkner Hospitals prior to joining the faculty, and is board certified in neurology and headache medicine.
 
Her research interests include headache epidemiology and management as well as medical education. She was the recipient of a 2011 American Headache Society Fellowship Award. Dr. Burch is also an associate editor for the journal Headache: The Journal of Head and Face Pain.
1. Classify patients by migraine type and appreciate the significance of classification on treatment of acute attacks and prophylaxis.  
2. Understand the impact of dosage forms and delivery systems on efficacy and patient satisfaction. 
3. Summarize recent research on new investigational targets for acute migraine that have the potential to be incorporated into future standards of care. 
4. Understand the importance of minimizing and managing acute attacks to prevent progression.

Statement of Need/Program Overview
Migraine is a disabling, recurrent, hereditary neurovascular headache disorder that affects millions worldwide. It is one of the most commonly encountered neurological disorders in the United States, affecting 16% to 22% of US adults at some time in their lives.
 
Despite the significant burden of migraine, approximately 50% of those with frequent and/or severe episodes do not seek out professional treatment. Moreover, among those seeking help, more than 40% have unmet treatment needs and treatment satisfaction, although greatly improved with the development of triptans, still hovers around only 70%. Studies suggest that only 26% of migraineurs successfully transverse all barriers associated with medical consultation, diagnosis, treatment, and ongoing care associated with migraine, and persistently low levels of acute migraine treatment optimization contribute to the heavy burden of this condition. These discouraging figures underscore the need for improved treatment and management of acute migraine.
 
Learning Goal/Purpose
This activity is designed to assist learners in reviewing key aspects in the evidence- and guidelines-based diagnosis and treatment of patients with migraine headaches.
 
Learning Objectives
After completing this activity, the participant should be better able to:
  1. Classify patients by migraine type and appreciate the significance of classification on treatment of acute attacks and prophylaxis
  2. Understand the impact of dosage forms and delivery systems on efficacy and patient satisfaction
  3. Summarize recent research on new investigational targets for acute migraine that have the potential to be incorporated into future standards of care
  4. Understand the importance of minimizing and managing acute attacks to prevent progression
     
Program Agenda
This self-assessment will review:
  • Pharmacologic Management of Acute Migraine Attacks
  • Prophylactic Treatment
  • Medications With Established or Probable Efficacy for the Treatment of Migraine
  • Migraine Progression and Medication Use/Overuse
  • Investigational Drugs
Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Medical Education Resources (MER) and ReardenCME. MER is accredited by the ACCME to provide continuing medical education for physicians.
 
Credit Designation
Medical Education Resources designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
Nursing Credit
Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
 
This CE activity provides 1.5 (one and a half) contact hours of continuing nursing education.
 
Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1.5 (one and a half) contact hours.
 
Disclosure of Conflicts of Interest
Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality activities that promote improvements or quality in health care and not the business interest of a commercial interest.
 
The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity: 
 
Dr. Rebecca Burch has nothing to disclose
Dr. Stephen Landy has received clinical research support from Dr. Reddy’s Laboratories
Dr. Brian Loftus has nothing to disclose
 
The content planners reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:
 
Julie Johnson, PharmD has no financial relationships to disclose.
Planners at ReardenCME have no financial relationships to disclose. 
 
Method of Participation
There are no fees for participating in and receiving credit for this activity. During the period June 2016 through June 2018, participants must 1) read the learning objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question in the answer key, and 4) complete the evaluation form in the activity.
 
A statement of credit will be issued only upon receipt of a completed activity evaluation and a completed posttest with a score of 60% or better. 
 
Disclaimer
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, ReardenCME, and/or Promius Pharma. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Medical Education Resources, ReardenCME, and/or Promius Pharma. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

This activity is jointly provided by Medical Education Resources (the learner may contact MER at 800-421-3756) and ReardenCME.
 
This activity is supported by an educational grant from Promius Pharma.
 
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COURSE VIEWING REQUIREMENTS
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Internet Explorer 9.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.