Online CME is Successful in Supporting the Clinical Integration of Behaviors Associated with the Diagnosis and Optimal Management of Migraine Among Neurologists, Primary Care Physicians, and other Specialists
Thomas Finnegan1, Kathy Merlo1, Catherine Capparelli1, Rashmi Halker Singh2, Dawn Buse3
1Medscape Education, 2Mayo Clinic, 3Albert Einstein College of Medicine
Objective:
This study assessed the ability of an online CME program to improve the clinical actions of physicians in the greatest position to impact migraine diagnosis and management. 
Background:
Migraine is a common chronic neurologic disease which remains underrecognized, underdiagnosed and undertreated. People who are members of underrepresented populations are at particular risk for receiving suboptimal care. 
Design/Methods:

The CME activity was a 45-minute video recorded and chapterized program on 5 topics, including: symptom burden, diagnosis, acute medication, preventive medication, and equitable care among in underrepresented populations. The impact of the education was measured with an intent to change survey, a validated surrogate measure for actual changes in clinical practice. 30-60 days after participation in the activity, learners were asked to complete a survey about the type of changes they made in practice based on the education and to identify any barriers to implementation. Data were collected from 2/29/2024 through 9/17/2024.

Results:

A total of 74 physicians in the target audience (12 neurologists, 51 PCPs, 1 obstetrician, and 10 other specialists) responded to the survey. Between 69%-87% reported that they have modified or are now integrating the following actions: routinely asking about migraine symptom burden and the number of migraine- and headache-free days per month; consider route of administration when recommending acute medication; counseling patients that 2 hour pain freedom is goal of acute medication treatment, discussing the goals of preventive therapies with patients, and identifying social determinants of health in all patients with migraine. Although 70%-80% of respondents reported having no barriers to implementing any of the changes, lack of time was the most frequently cited (14% selected this) barrier.  

Conclusions:

This study provides evidence that online CME encourages multiple physician groups to make practice changes supporting timely diagnosis and appropriate management. Future education should prioritize time-sensitive strategies for diagnosing and managing migraine.

10.1212/WNL.0000000000215285
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.