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Embracing Change in migraine management

Migraine management - Heba Bani Hani | Canadian Foundation for Pharmacy

Embracing Change in migraine management

Migraine affects one in every five households in Canada, yet the condition is often dismissed, underdiagnosed and mismanaged. When pharmacist Heba BaniHani recognized this care gap for people with migraine, she made it her mission to do something about it.

“My quest is to elevate the profile of the community pharmacist as an important part of migraine care,” she says. “It’s about educating pharmacists on migraine management and encouraging patients to go their pharmacist for migraine help, rather than getting stuck on long waitlists to see a specialist.”

She is making great progress on that mission so far. Since starting her appointment-based virtual practice focused on migraine management, BaniHani has helped more than 400 people living with migraine and trained hundreds of pharmacists in Canada and abroad on how to manage migraine in their own practices. She is also working with the international NGO organization Lifting the Burden with the purpose of leading and directing the Global Campaign Against Headache Official Relations with the World Health Organization to identify medications used to treat headaches and migraine around the world—and generate data that can help decision-makers assess medication use and provide practical evidence on the potential impact of leveraging pharmacists.

Born and raised in Jordan, BaniHani spent her early pharmacy career in industry managing product launches in the Middle East. Her career as a pharmacist in Canada started in 2010, when she pivoted to community and hospital pharmacy practice. She complimented her practice by solidifying her clinical knowledge with education on different therapeutic areas and attained an MBA in Healthcare & Life sciences from the university of Toronto in 2020 right at the start of Covid-19. That’s when she discovered her passion for migraine care and put all her expertise and education into a virtual practice determined to become one of the country’s leading migraine pharmacists.

Elevating the role of pharmacists

With support from the Canadian Foundation for Pharmacy’s Wellspring Leadership Awards, she completed a Master’s in headache disorders from the University of Copenhagen. “They didn’t accept pharmacists, but I wrote them a letter explaining what I was doing in Canada and became the first pharmacist ever accepted in the world,” she says. At the same time, BaniHani started working with the Migraine Pharmacy Network where she was training pharmacists in migraine management, working with patient advocacy groups and collaborating with pharma companies to ensure healthcare providers had information on the latest medications for migraine coming into Canada.

Heba says many physicians are overwhelmed by the sheer volume of conditions they have to manage in their practices and in the case of migraine, the finding the right treatment for patients can be time-consuming. She says medications most often used are non-migraine-specific, posing a challenge in titrating doses and managing tolerability and adherence. “This is where I come in as pharmacist and can explain treatment options and lifestyle changes that may help,” she says. “I can also help manage expectations and discuss issues around medication overuse headaches, which are common for people with migraine. I can advocate for my patients with their family physicians and help them navigate issues like access to medications and coverage”

In her current practice (https://www.themigrainepharmacist.com/), BaniHani meets with patients virtually for one hour (at $120 per session) to go over their current medication use, symptoms and lifestyle, and then develops a treatment plan. She shares her recommendations in a document with the patient’s physician and then follows up in two months’ time to check on their progress (Follow-up appointments are $60). “In that first assessment, I give them advice and a plan, then connect them back to their physician and community pharmacy,” she says. “I’m also available to answer questions and help them identify/manage changes that happen when they start.” If they can’t follow the treatment plan for whatever reason, BaniHani will also go back to their physician with an alternative.

While she doesn’t advertise her services in a traditional sense, she is active on social media and partners with other healthcare professionals who refer patients. BaniHani also conducts monthly webinars with Migraine Canada titled “Ask Your Pharmacist,” where she talks to other pharmacists and patients about ways to manage pain associated with migraine. She also volunteers for the Canadian Migraine Society, answering questions online from people suffering with chronic migraine.

She has developed training sessions for pharmacists through various pharmacy associations and was a key part of creating the Canadian Headache Society’s Mastermind in Migraine Management program in 2023, which has been completed by some 400 pharmacists already. She was also involved in the international series of webinars Master Class in Migraine that has reached thousands of healthcare providers across the globe. “I’m trying to empower as many pharmacists into taking on migraine as possible,” she says.

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