Mia T Minen1, Jackie Yang2, Sait Ashina3, Noah Rosen4, Robert Duarte4. 1. Departments of Neurology and Public Health, NYU Langone Health, New York, New York, USA. 2. NYU Grossman School of Medicine, New York, New York, USA. 3. Department of Neurology and Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 4. Pain and Headache Center, Northwell Department of Neurology, Zucker School of Medicine, Great Neck, New York, USA.
Abstract
OBJECTIVE: Pain specialists treat patients with headache and interface with those who use opioids more so than neurologists and headache specialists. We assessed the headache medicine knowledge and needs of pain specialists. DESIGN/ SETTING: Cross-sectional online survey. SUBJECTS: Members of the American Academy of Pain Medicine. METHODS: Survey was based on a prior survey of primary care providers' knowledge and needs and was iteratively updated by four headache specialists, two with pain medicine affiliations. RESULTS: Of the 105 respondents, 71.4% were physicians, 34.3% were women, and they averaged 20.0 ± 13.6 years in practice. The most common specialty was anesthesia (36.1%, n = 35/97) followed by neurology (14.4%, n = 14/97). About half of providers (55.7%, n = 34/61 and 53.3%, n = 32/60) were familiar with the American Academy of Neurology Guidelines for pharmacological migraine prevention and the Choosing Wisely Campaign recommendations for limiting neuroimaging and opioids. Less than half of all providers (39.7%, n = 23/58) were familiar with the American Headache Society guidelines for emergency management of migraine. Providers were aware of Level A evidence-based nonpharmacological therapies, with over three-fourths recognizing cognitive behavioral therapy (80.7%, n = 50/62) and biofeedback (75.8%, n = 47/62) as evidence-based interventions. About 80% of providers (n = 50/64) estimate making migraine diagnoses in ≤50% of their patients with headache. Providers consider starting preventive headache therapy at 7.1 ± 3.9 days/month and report referring 34.3%±34.2% of patients to behavioral interventions. CONCLUSIONS: Dissemination and implementation of headache guidelines is needed for pain medicine specialists. Providers may need help diagnosing migraine based on currently accepted guidelines and referring for evidence-based behavioral therapies.
OBJECTIVE: Pain specialists treat patients with headache and interface with those who use opioids more so than neurologists and headache specialists. We assessed the headache medicine knowledge and needs of pain specialists. DESIGN/ SETTING: Cross-sectional online survey. SUBJECTS: Members of the American Academy of Pain Medicine. METHODS: Survey was based on a prior survey of primary care providers' knowledge and needs and was iteratively updated by four headache specialists, two with pain medicine affiliations. RESULTS: Of the 105 respondents, 71.4% were physicians, 34.3% were women, and they averaged 20.0 ± 13.6 years in practice. The most common specialty was anesthesia (36.1%, n = 35/97) followed by neurology (14.4%, n = 14/97). About half of providers (55.7%, n = 34/61 and 53.3%, n = 32/60) were familiar with the American Academy of Neurology Guidelines for pharmacological migraine prevention and the Choosing Wisely Campaign recommendations for limiting neuroimaging and opioids. Less than half of all providers (39.7%, n = 23/58) were familiar with the American Headache Society guidelines for emergency management of migraine. Providers were aware of Level A evidence-based nonpharmacological therapies, with over three-fourths recognizing cognitive behavioral therapy (80.7%, n = 50/62) and biofeedback (75.8%, n = 47/62) as evidence-based interventions. About 80% of providers (n = 50/64) estimate making migraine diagnoses in ≤50% of their patients with headache. Providers consider starting preventive headache therapy at 7.1 ± 3.9 days/month and report referring 34.3%±34.2% of patients to behavioral interventions. CONCLUSIONS: Dissemination and implementation of headache guidelines is needed for pain medicine specialists. Providers may need help diagnosing migraine based on currently accepted guidelines and referring for evidence-based behavioral therapies.
Authors: Serena L Orr; Benjamin W Friedman; Suzanne Christie; Mia T Minen; Cynthia Bamford; Nancy E Kelley; Deborah Tepper Journal: Headache Date: 2016-06 Impact factor: 5.887
Authors: Mia Minen; Ashna Shome; Audrey Halpern; Lori Tishler; K C Brennan; Elizabeth Loder; Richard Lipton; David Silbersweig Journal: Headache Date: 2016-04-01 Impact factor: 5.887