John R. Graham Headache Center pilots group appointments to improve patient access

On May 17, the New York Times reported on the FDA’s approval of a new migraine medication called Aimovig. On May 18, Chandler Kaplan, Practice Manager for the John R. Graham Headache Center at Brigham and Women’s Faulkner Hospital, had 60 Patient Gateway messages from patients interested in trying the new treatment. With the clinic’s physicians booking appointments months ahead, the team decided this was a great opportunity to try something new in order to improve access: group appointments.

“Aimovig is a new treatment. It targets a molecule that we all produce called CGRP (or calcitonin gene-related peptide), which is thought to be involved in migraine pathophysiology. The research into this peptide and its role in migraine has been going on for years. And now, finally, we have approval from the FDA for this treatment,” says John R. Graham Headache Center Physician Assistant Melissa Darsey. “A lot of our patients are excited and willing to try something new because many of them have not had success with other preventive and supportive treatments for migraine.”

Since so many patients were immediately interested, and the physicians in the clinic already had such a busy schedule, it made sense to try to accommodate groups of patients at one time. The clinic quickly organized a series of information sessions led by a clinician from the clinic and attended by both Kaplan and Darsey. The goal was to educate existing patients on the new treatment and talk about its pros and cons. After the information sessions, patients had the chance to meet one on one with a prescriber in order to get their prescription. Kaplan explains, “It seemed like a perfect opportunity for group visits. We’re simply offering information about the new drug, which is the same for each patient.”

Each session, which was billed as a low-level office visit, had space for 10 patients. In a two-week span, the clinic was able to see 50 patients. Kaplan says, “It’s a great way to improve access and get information to our patients.”

In addition to accommodating so many patients in such a short time, the group sessions had other benefits. “With chronic migraine or chronic pain, oftentimes people feel very isolated. To have a group visit with others in the same situation who understand where they are coming from is a great benefit,” says Darsey. “They were even able to share tips and tricks related to insurance coverage.”

And feedback from patients has been very positive. “People seemed very happy with how it went, even though their face-to-face time with their clinician was shorter,” says Darsey. “Plus, now when patients come to a group meeting to ask about Aimovig, we can then focus on other topics when I see them for a regular office visit.”

Since the pilot program was such a success, the clinic is now looking for other topics with which to try group appointments. But first they need to schedule additional group appointments for Aimovig as demand is still high. Darsey says, “We have a large patient population that may benefit from trialing this treatment.”