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National Headache Foundation presents
Clinical Challenges
Optimizing Assessment and
Counseling of Patients with Headache
This activity is jointly sponsored by
CME Consultants and Educational Awareness Solutions
Editorial Advisory Board
Roger K Cady, MD; Kathleen (Cas) Cahill, DNP, ARNP; Lisa K Mannix, MD; John F Kramer, BA, PA-C; Richard G Wenzel, PharmD
    
Target Audience
This activity was designed for a nationwide audience of Nurse Practitioners who wish to expand their knowledge of the epidemiology, pathophysiology, prevention, and treatment of headache. This knowledge will help these healthcare professionals enhance their management and communication skills when interacting with patients who suffer from headache.
Credits Available: CE
Original Release/Expiration Dates
April 30, 2008; Valid for credit through April 30, 2009.
Program Overview
In the United States alone, recurring headache affects more than 45 million individuals, and migraine accounts for more than half of these cases. Primary headache, which comprises migraine and migraine variants, tension-type headache, and cluster headache, can have a significant impact on patient quality of life and productivity.
Patients with headache generally present in the primary care setting with either a recent unstable headache problem or an established pattern of stereotypic headaches. For those with a new or different headache problem, a comprehensive assessment designed to rule out neurological or other secondary causes is paramount. For those with well-established, stable patterns of headaches that disrupt their lives, the likely diagnosis is migraine. A critical step in assessing either presentation is a comprehensive headache history and medical evaluation. Due to the demands of today's medical practice, healthcare providers must be efficient in evaluating a patient presenting with headaches, but several factors may confound this effort. Patients may not adequately communicate the characteristics of their headache and may omit relevant information from their descriptions, particularly when asked "yes/no" questions by their doctors. This can lead to an erroneous diagnosis and inadequate or inappropriate treatment. In addition to medications, the treatment regimen may also include headache education, counseling, stress management, and biofeedback. Patients may also require assistance with trigger identification and avoidance, medication compliance, managing medication side effects, and monitoring treatment results. Again, the physician rarely has sufficient time to assist the patient with all these aspects of headache evaluation and treatment in a single visit.
Fortunately, however, within busy medical offices, there are Nurse Practitioners (NPs) and other allied health professionals who play a critical role in patient assessment, treatment, and counseling. Patients may feel more comfortable speaking to these professionals than to their physicians. Recognizing that headache affects a substantial number of individuals, and given the time limitations encountered by physicians as well as the necessity for comprehensive headache assessment and counseling, there is clearly a need to educate NPs and other allied health professionals regarding headache management and arm them with the necessary knowledge and tools to effectively improve outcomes for those who suffer headache.
Faculty
Roger K Cady, MD
Banyan Group, Inc
Headache Care Center
Clinvest Research
Springfield, Missouri
Kathleen (Cas) Cahill, DNP, ARNP
Assistant Professor, College of Nursing
University of South Florida
Consultant, Headache/Pain Management Center
Tampa General Hospital
Tampa, Florida
Lisa K Mannix, MD
Medical Director
Headache Associates
Cincinnati, Ohio
John F Kramer, BA, PA-C
Center for Neurological Disorders
Milwaukee, Wisconsin
Richard G Wenzel, PharmD
Diamond Headache Clinic Inpatient Unit
Saint Joseph Hospital
Chicago, Illinois
Disclosure Statement
In direct response to the September 2004 Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, CME Consultants issued a conflict of interest policy dated January 2, 2005, and revised on November 30, 2005. The policy states that the disclosure of potential financial conflicts of interest within the past 12 months must be made and resolved prior to date of CME/CE activity. The following conflicts have been managed and resolved though an Independent Review Committee of CME Consultants. Our intent is to assist learners in assessing the potential for bias in information that is presented during the CME/CE activity.
The faculty is also aware that it is their responsibility to inform the audience if discussion of non-FDA-approved uses of pharmaceuticals, medical equipment, prostheses, etc, will be included in their presentations.
Roger K Cady, MD
Discloses the following:
Advisory Boards: Allergan Inc, Atrix Laboratories, Capnia Inc, Endo Pharmaceuticals, GlaxoSmithKline plc, Johnson & Johnson, MedPointe, Merck & Co Inc, Ortho-McNeil Inc, Winston Laboratories Inc
Consultant: Aradigm Corp, GlaxoSmithKline plc, Jazz Pharmaceuticals Inc, Merck & Co Inc, Ortho-McNeil Inc
Research Grants: Abbott Laboratories, Advanced Bionics Corp, Alexza Pharmaceuticals Inc, Alizyme plc, Allergan Inc, Capnia Inc, Cipher Pharmaceuticals Inc, Eisai Inc, GlaxoSmithKline plc, Jazz Pharmaceuticals Inc, Johnson & Johnson, MAP Pharmaceuticals Inc, Matrixx Initiatives Inc, Merck & Co Inc, Neuralieve Inc, Novartis AG, Ortho-McNeil Inc, Pfizer Inc, POZEN Inc, Schwarz Pharma AG, TorreyPines Therapeutics, Vernalis plc
Kathleen (Cas) Cahill DNP, ARNP
Discloses the following:
Honoraria: Ortho-McNeil Neurologics Inc
Lisa K Mannix, MD
Discloses the following:
Advisory Boards: Allergan Inc, Endo Pharmaceuticals, GlaxoSmithKline plc, Merck & Co Inc, Ortho-McNeil Neurologics Inc, Pfizer Inc
Consultant: Allergan Inc, Endo Pharmaceuticals, GlaxoSmithKline plc, MAP Pharmaceuticals, Merck & Co Inc, Ortho-McNeil Neurologics Inc
Honoraria: Allergan Inc, Endo Pharmaceuticals, GlaxoSmithKline plc, Merck & Co Inc, Ortho-McNeil Neurologics Inc
Research Grants: Alexza Pharmaceuticals Inc, Allergan Inc, Endo Pharmaceuticals, GlaxoSmithKline plc, Merck & Co Inc, Ortho-McNeil Neurologics Inc, POZEN Inc, TorreyPines Therapeutics
Speaker: Endo Pharmaceuticals, GlaxoSmithKline plc, Merck & Co Inc, Ortho-McNeil Neurologics Inc
John F Kramer, BA, PA-C
Discloses the following:
Consultant: Bayer AG, Biogen Idec, Merck & Co Inc, EMD Serono/Pfizer, Teva Neuroscience Inc
Speaker: Ortho-McNeil Neurologics Inc
Richard G Wenzel, PharmD
Discloses the following:
Advisory Boards: Allergan Inc, GlaxoSmithKline plc
Honoraria: Allergan Inc
The planners, managers, and anyone in a position to control the content of CME/CE activities are also required to report any conflicts of interest. The following conflicts have been managed and resolved through CME Consultants' Independent Review Committee:
| Planner/Manager |
Company and Relationship |
| Viji Anantharaman, Medical Writer |
Vitae Pharmaceuticals - Employee (spouse)
Vitae Pharmaceuticals - Salary (spouse)
Vitae Pharmaceuticals - Stock Options (spouse) |
Samantha Mattiucci, PharmD,
CME Consultants |
Nothing to disclose |
Susan Coutu-Robidoux, Project Manager,
CME Consultants |
Nothing to disclose |
Kristen Kachuba, Senior Project Manager,
Educational Awareness Solutions |
Nothing to disclose |
Accreditation and Credit Designation Statements
This activity was planned in accordance with AANP's CE Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs.
This activity is jointly sponsored by CME Consultants and Educational Awareness Solutions.
This program has been approved for 6.0 contact hours of continuing education (which includes 1.5 hours pharmacology) by the American Academy of Nurse Practitioners. Program ID 0711520.
A certificate is awarded for successful completion of this educational offering. Successful completion is defined as a Post-Test score of at least 70%.
Estimated Time to Complete
The estimated time to complete this activity, including the Post-Test and Evaluation, is 6 hours.
Educational Objectives
This Clinical Challenges is intended to broaden knowledge of headache, enhance skills in caring for and counseling patients, and develop a high level of comfort addressing issues of concern to the patients and their families. Upon completion of this activity, participants should be able to:
- Describe the impact of headache on society and the healthcare system
- Recognize the characteristics of migraine, tension-type headache, and cluster headache
- Record a comprehensive headache history
- Apply the steps involved in diagnosis and differential diagnosis of headache
- Identify classes of drugs used in the acute treatment of migraine, tension-type headache, and cluster headache
- Recognize patients who require prophylactic headache therapy
- Identify classes of drugs used in the prophylactic treatment of migraine, tension-type headache, and cluster headache
- List the contraindications for the common drug classes used in headache treatment
- Describe three nonpharmacological headache techniques
- Summarize the link between headache and depression/anxiety
- Describe the association between psychosocial stress and headache
- Recognize the impact of headache on social and physical functioning
- Summarize the steps to counsel a headache patient before and during headache treatment
- Recognize the steps involved in diagnosis of migraine
- Identify the factors determining choice of treatment of migraine
- Explain how to counsel a patient before initiating migraine therapy
- Distinguish the issues that need to be addressed during follow-up of a migraine patient
How to Obtain Credit
In order to receive your CE credits, you are requested to review the material in full, complete the Post-Test, Evaluation, and Certificate Request Forms and return to CME Consultants via mail or fax.
Click here to request home study kit
FDA Disclosure
The contents of some of CME/CE activities may contain discussions of nonapproved or off-label uses of some of the agents mentioned. Please consult the prescribing information for full disclosure of approved uses.
Commercial Support
This activity was made possible through an educational grant provided by Merck & Co, Inc.
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