Improving Health Outcomes in Chronic Migraine:
Obviating Medication Overuse/Applying Clinical Guidelines and Novel Data

Please review the CME/CE information below, and click “continue” to view the activity.

Intended Audience

This activity is intended for managed care pharmacists and clinicians interested in the management of chronic migraine.

Statement of Need

Chronic migraine (CM) is a highly disabling neurologic disorder, with heterogeneous characteristics resulting in a range of symptom profiles, burden, and disability, that remains largely underdiagnosed and undertreated. Affecting nearly 2% of the general population, CM is one of the most disabling of the primary headache disorders, imposing considerable economic burden while interfering with social, occupational, and educational functioning; it remains an enormous challenge in neurologic and headache practices.

Treatment of CM has evolved into a multifaceted approach, including lifestyle modification, trigger management, behavioral therapy, pharmacologic therapy, education, support, management of expectations, and close follow-up. Topiramate, divalproex, and onabotulinumtoxinA have been evaluated as prophylactic treatment of CM in randomized, double-blind, placebo-controlled or active comparator-controlled trials. OnabotulinumtoxinA received approval October 15, 2010, from the US Food and Drug Administration for prophylactic treatment of CM. (Please note, the conference in this webcast occurred October 14, 2010.)

This symposium will review pathophysiology, diagnosis, optimal management, and clinical practice guidelines for CM. Faculty also will discuss current clinical trials on medication overuse and CM prophylaxis.

Educational Objectives

At the conclusion of this activity, participants should be better able to:

Accreditation and Certification

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Annenberg Center for Health Sciences at Eisenhower and CogniMed Inc. The Annenberg Center is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Annenberg Center for Health Sciences at Eisenhower is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program has been developed according to the ACPE Criteria for Quality and is assigned ACPE Universal Program #0797-9999-10-026-H01-P. This program is designated for up to 1.5 contact hours (0.15 CEUs) of continuing pharmacy education credit.

There is no charge for this activity. Statements of Credit will be provided by mail following activity participation and upon completion and electronic submission of the posttest and evaluation to CogniMed Inc. A link to the evaluation is provided within the activity. Please allow 4 to 6 weeks for the delivery of your statement.


David W. Dodick, MD, FRCPC, FACP
Professor of Neurology
Mayo Clinic College of Medicine
Scottsdale, Arizona


Dawn C. Buse, PhD
Assistant Professor, Department of Neurology
Albert Einstein College of Medicine of Yeshiva University
Assistant Professor, Clinical Health Psychology Doctoral Program
Ferkauf Graduate School of Psychology of Yeshiva University
Director of Behavioral Medicine
Montefiore Headache Center
New York, New York

Matthew P. Mitchell, PharmD, MBA, MHP
Manager, Pharmacy Services
Murray, Utah

Disclosure Statement

It is the policy of the Annenberg Center to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will be discussion about the use of products for non–FDA-approved applications.

In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Annenberg Center policy, the following disclosures have been made:

All staff at the Annenberg Center for Health Sciences at Eisenhower have nothing to disclose.

All staff at CogniMed Inc. have nothing to disclose.

David W. Dodick, MD, FRCPC, receives research support from Advanced Neuromodulation Systems, Inc.; Medtronic, Inc.; and St. Jude Medical, Inc. He is a consultant for Alexza Pharmaceuticals, Inc.; Allergan, Inc.; Boston Scientific Corporation; Bristol-Myers Squibb Company; CogniMed Inc.; Coherex Medical, Inc.; Eli Lilly and Company; Impax; Kowa Pharmaceuticals America, Inc.; MAP Pharmaceuticals, Inc.; Merck & Co., Inc.; Miller Medical; Minster Pharmaceuticals; Neuralieve Inc.; NeurAxon; Novartis; NuPathe Inc.; Pfizer Inc; SAGE Publications; and Zogenix, Inc.

Dawn C. Buse, PhD, is a consultant for Allergan, Inc.; Endo Pharmaceuticals Inc.; Iroko Pharmaceuticals; and MAP Pharmaceuticals, Inc.

Matthew P. Mitchell, PharmD, MBA, MHP, is a consultant for Allergan, Inc.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of the Annenberg Center and/or its agents. As in all educational activities, we encourage the practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient’s unique clinical situation. The Annenberg Center disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

This activity will address professional practice gaps in knowledge.

This program may contain discussion of investigational uses of pharmacologic and nonpharmacologic therapies. Individual clinical judgments should be used in all patient care decisions.

This activity is an enduring material and consists of a Web posting. Successful completion is achieved by viewing the material, reflecting on its implications in your practice, and completing the assessment component.

The estimated time to complete this activity is 1.5 hours.

This activity was originally released December 31, 2010, and is available for credit through December 31, 2011.