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Abstract Details

Headache diagnosis and treatment: A knowledge and needs assessment among pain medicine specialists
Headache
Headache Posters (7:00 AM-5:00 PM)
130

Migraine remains an underdiagnosed and undertreated primary headache disorder. One out of 10 seek care for migraine with a pain specialist. Pain specialists are much more likely to interface with headache patients who use opioids (75% of patients) compared to neurologists and headache specialists.

To assess headache medicine knowledge and needs of pain specialists.

A cross-sectional anonymous self-reported survey was distributed (7/17/20-8/21/20) via email listserv among members of the American Academy of Pain Medicine. The survey was based on a prior survey on primary care providers’ knowledge and needs and was iteratively updated by four headache specialists, two with pain medicine affiliations.

The 105 respondents were 20.0 ± 13.6 years (mean±SD) in practice, 34.6% were female, and 71.4% were physicians. The most common specialty was anesthesia (36.1%, n=35/97) followed by neurology (14.4%, n=14/97).  About half (55.7%, n=34/61 and 53.3%, n=32/60) were familiar with the American Academy of Neurology Guidelines for pharmacological treatment for migraine prevention and with the Choosing Wisely Campaign recommendations for limiting neuroimaging and opioid prescriptions. Less than half (39.7%, n=23/58) were familiar with the American Headache Society guidelines for management of migraine in an emergency setting. Providers were aware of the 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. Regarding clinical practice, almost 80% of providers (n=50/64) estimate making migraine diagnoses in <50% of their headache patients. Providers would consider starting preventive headache therapy at 7.1± 3.9 days/month. On average, providers referred 34.3%±34.2% of patients to behavioral interventions.

Dissemination and implementation of headache guidelines is needed for pain medicine specialists. Also, providers may need help translating some of their knowledge base to clinical practice in diagnosing migraine, considering preventive treatment around 4 headache days/month, and referring for evidence-based behavioral therapies.
Authors/Disclosures
Jackie Yang
PRESENTER
Jackie Yang has nothing to disclose.
Robert A. Duarte, MD (Northwell) Dr. Duarte has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for LILLY . Dr. Duarte has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan . Dr. Duarte has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for LILLY . Dr. Duarte has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for LILLY . Dr. Duarte has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Allergan. Dr. Duarte has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Duarte has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for HPMB.
Sait Ashina, MD (Beth Israel Deaconess Medical Center, Harvard Medical School ) Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Ashina has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impel Neuropharma. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer.
Noah Rosen, MD, FAAN Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen/ Novartis. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Speaker with American Headache Society.
Mia T. Minen, MD, FAAN (NYULMC Neurology) The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI .