The Role of Advanced Practice Practitioners in Managing Migraine

Discover how nurse practitioners and physician assistants can help you better manage migraine with expanded access to medical care, education, and ongoing support

Managing migraine is a continual process that requires a support team of medical providers. Advanced practice practitioners (APPs) can be an important part of that team. We discussed the role of APPs in migraine care with Dr. Maureen Moriarty, a doctor of nursing practice and nurse practitioner at MedStar Georgetown University Hospital.

What Is an APP?

Advanced practice practitioners, which include nurse practitioners (NPs) and physician assistants (PAs), provide medical care and education under the supervision of a licensed doctor. They can do many of the same things as a doctor, including seeing and following up with patients, evaluating new patients, reviewing and ordering tests, doing procedures, providing education, writing prescriptions, and executing research activities. When working in a larger practice, APPs share the workload with busy doctors. This reduces patient wait times for appointments and provides more timely, consistent care for chronic conditions and diseases.

APPs work in close collaboration with licensed physicians, so patients receive quality care from a team of providers. “Our [healthcare] landscape has moved from practicing in silos to really working in multidisciplinary teams,” says Dr. Moriarty, adding that it is a best practice. “If you look at outcome studies, in terms of quality, measures, patient outcomes, access to care, incorporating the APP can be very helpful.”

The Difference Between an NP and a PA

Both NPs and PAs initially train as primary care clinicians, so they all bring that level of advanced education to their practice. But NPs and PAs undergo different paths of education and training.

PAs get an education in the medical model. Their training reflects that focus on disease-centered medical care. They do not need to have a master’s degree, but many do hold a certification. PAs always work in collaboration with a doctor and do not have an independent practice.

NPs are registered nurses who gain clinical experience before going back to earn their advanced degree. “Even though [NPs] do clinical evaluation and diagnosis, they also bring to the table those behavioral skills that one obtains by getting that baseline nursing education,” explains Dr. Moriarty. NPs can work with a doctor or within their own practice.

Some NPs and PAs will receive extra training and work in specialized areas like headache medicine.

The Role of an APP in Managing Migraine

According to Dr. Moriarty, one of the biggest challenges many patients face is access to care. The U.S. is experiencing a shortage of headache specialists and neurologists—a problem that is only growing as the population ages. Because APPs can treat migraine, they can improve this issue. In fact, the American Headache Society recently launched a program to educate and train primary care practitioners, including APPs, in diagnosing and treating migraine.

The specific role advanced practice practitioners play may vary from practice to practice. But they may have a hand in your initial evaluation by taking your health history, completing portions of your physician exam and working with the doctor to develop a plan of care. They may also be your point of contact when you call the office with questions or need a virtual visit.

Advanced practice practitioners can serve as a primary care provider. This is especially the case with stable chronic migraine that may require follow-up visits. When patients need medication or have an issue, being able to see an APP means they can avoid visiting the emergency room if their physician is not available. By providing more access and education, APPs also give patients the tools to better manage their migraine day to day, ultimately lowering healthcare costs and improving overall quality of care.

Additional Benefits of Having Access to an APP

Having an APP on your support team provides added benefits beyond direct medical care. As Dr. Moriarty points out, APPs are “educated in educating patients,” so they are helpful resources for information and answering questions.

Many APPs also perform work in clinical research, bringing additional insight and perspective to your care. They can help navigate prior authorizations and other paperwork, which is often a complex aspect of medical care for people with chronic diseases like migraine. They can also strengthen your support team as a whole by providing a wider range of services and better access and delivery of care.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.