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Calgary Headache Assessment & Management Program   at
South Health Campus
Specialty: Neurology
Connect Care Department: CGY SHC CHAMP
Estimated time to routine appointment: Within 18 months
Alberta Health Services - Calgary Zone
SERVICE DESCRIPTION
Provides support, treatment, management, and education for adults with significant migraine or other headache issues.The Calgary Headache Assessment and Management Program is an academic, tertiary headache referral centre aimed at providing advanced treatments for patients with complex headache problems and advancing our understanding of the mechanisms and treatments of headache and facial pain. We provide access to headache medicine subspecialists, advanced treatments, educational programs and behavioral as well as medication strategies for managing headache. Please note that secondary or emergent causes of headache must be excluded prior to referral to our clinic.

This service:
  • offers workshops, lectures, and education
  • teaches skills to manage headaches
  • provides medication and treatment options
Provides support, treatment, management, and education for adults with significant migraine or other headache issues.The Calgary Headache Assessment and Management Program is an academic, tertiary headache referral centre aimed at providing advanced treatments for patients with complex headache problems and advancing our understanding of the mechanisms and treatments of headache and facial pain. We provide access to headache medicine subspecialists, advanced treatments, educational programs and behavioral as well as medication strategies for managing headache. Please note that secondary or emergent causes of headache must be excluded prior to referral to our clinic.

This service:
  • offers workshops, lectures, and education
  • teaches skills to manage headaches
  • provides medication and treatment options
ELIGIBILITY REQUIREMENTS
Inclusion Criteria
Adult patients with complex primary and secondary headache problems: Patients with headache in pregnancy
  • Cluster headache and trigeminal autonomic cephalgias
  • Migraine with atypical features
  • Migraine having failed three or more preventative medications or where advanced or interventional treatments may be needed
  • Patients who may be interested in participating in clinical trials
  • Typical Migraine/ Tension Type Headache, failed ≥ 4 preventatives* (with proper dose and duration) Including CGRP antagonist Undifferentiated chronic headache, failed > 4 preventatives (with proper dose and duration)
  • Migraine Variants (hemiplegic migraine, cyclic vomiting syndrome)
  • Trigeminal Neuralgia, failed >3 preventatives (with proper dose and duration) Undifferentiated Facial Pain, failed >3 preventatives (with proper dose and duration)
  • Trigeminal Autonomic Cephalgia symptoms (TAC), failed 2 preventatives
  • Low pressure positional headache present ≥ 3 months.
  • IIH with headache but without papilledema with frequent headache ≥ 3 months, and failed > 3 preventives. (with proper dose and duration)
Exclusion Criteria
  • CHAMP does NOT accept out of province or north of Red Deer referrals. Patients from North of Red Deer should be referred to neurologists in Red Deer or Edmonton.
  • The CHAMP program does not manage patients with headache who have untreated opioid dependency, as appropriate resources are not available. Patients who have chronic post-traumatic headache with no features of underlying primary headache disorders should be referred to a chronic pain clinic.
  • The majority of patients with migraine are more suitable for General Neurology or a Family Medicine Migraine Specialist and do not require CHAMP clinic.
Inclusion Criteria
Adult patients with complex primary and secondary headache problems: Patients with headache in pregnancy
  • Cluster headache and trigeminal autonomic cephalgias
  • Migraine with atypical features
  • Migraine having failed three or more preventative medications or where advanced or interventional treatments may be needed
  • Patients who may be interested in participating in clinical trials
  • Typical Migraine/ Tension Type Headache, failed ≥ 4 preventatives* (with proper dose and duration) Including CGRP antagonist Undifferentiated chronic headache, failed > 4 preventatives (with proper dose and duration)
  • Migraine Variants (hemiplegic migraine, cyclic vomiting syndrome)
  • Trigeminal Neuralgia, failed >3 preventatives (with proper dose and duration) Undifferentiated Facial Pain, failed >3 preventatives (with proper dose and duration)
  • Trigeminal Autonomic Cephalgia symptoms (TAC), failed 2 preventatives
  • Low pressure positional headache present ≥ 3 months.
  • IIH with headache but without papilledema with frequent headache ≥ 3 months, and failed > 3 preventives. (with proper dose and duration)
Exclusion Criteria
  • CHAMP does NOT accept out of province or north of Red Deer referrals. Patients from North of Red Deer should be referred to neurologists in Red Deer or Edmonton.
  • The CHAMP program does not manage patients with headache who have untreated opioid dependency, as appropriate resources are not available. Patients who have chronic post-traumatic headache with no features of underlying primary headache disorders should be referred to a chronic pain clinic.
  • The majority of patients with migraine are more suitable for General Neurology or a Family Medicine Migraine Specialist and do not require CHAMP clinic.
REFERRAL SUBMISSION INSTRUCTIONS
Follow these steps before sending a referral. Incomplete referrals may be returned or declined.
  1. Review the Service Description, Eligibility Requirements, Pathways and Advice options to ensure your patient is appropriate for this service.
  2. Click the (+) icon in the Referral Guidelines table to view the required information and investigations that must accompany the referral.
  3. Follow the applicable Referral Process and submit referral.
Follow these steps before sending a referral. Incomplete referrals may be returned or declined.
  1. Review the Service Description, Eligibility Requirements, Pathways and Advice options to ensure your patient is appropriate for this service.
  2. Click the (+) icon in the Referral Guidelines table to view the required information and investigations that must accompany the referral.
  3. Follow the applicable Referral Process and submit referral.
Referral instructions for primary care, community care, private
providers etc. who do not send referrals via Connect Care.
REFERRAL PROCESS - FOR NON-CONNECT CARE USERS
Complete the referral form and fax it to the service using the contact information in this profile.
Complete the referral form and fax it to the service using the contact information in this profile.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Neurology, type CGY SHC CHAMP in the “To Department” section and complete order.
Send an Internal Referral using the Ambulatory Referral Order to Neurology, type CGY SHC CHAMP in the “To Department” section and complete order.
ADDITIONAL SERVICE DETAILS
Referrals are received and triaged at the Neurology Central Access and Triage and then appointments are booked at the appropriate location based on the patients address.
Referrals are received and triaged at the Neurology Central Access and Triage and then appointments are booked at the appropriate location based on the patients address.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 14 days.
  • Wait list status update every 90 days.
  • Appointment outcome to referral source within 30 days.
 
CLICK + TO VIEW REFERRAL GUIDELINES
Routine Reason for Referral
Access Targets convey the clinically appropriate timeframe patients should be seen within, by reason for referral and priority level.
Access Target
Required Information/Investigations
Investigation Timing
Additional Details
Cluster headache
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current
    Individual attack formation 3 hours or less

    Facial pain
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current

    Hemicrania continua
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current
    Continuous unilateral headache, always on same side

    Migraine
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current

    Orthostatic headache
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current
    Orthostatic headache (worse on standing) suggestive of intracranial hypotension with CSF leak.

    Tension-type headache
  • Medication List (Dose, Frequency, route)
  • Past Medical History
  • Patient's age at onset of current type of headache?
  • Please indicate the number of days with headache per month:
    • 0-5 days
    • 6-10 days
    • 11-14 days
    • 15-29 days
    • Every day facial pain syndrome?
  • Has the patient suffered a previous neck or head injury which appears related to the current headache problem?
  • Is headache precipitated (not just aggravated) by cough, exertion, or straining?
  • Is headache worse with lying down?
  • Unexplained neurological examination findings, if yes - list findings
  • Medications tried in the past and their effectiveness
  •  
    Within 1 month

  • Describe acute (symptomatic) medication use:
    • Patient uses combination analgesics, codeine-containing analgesics, triptans, tramadol, or ergotamines on 10 days a month or more.
    • Patient uses plain acetaminophen or NSAIDs on 15 days a month or more
    • Patient uses opioids other than codeine on 10 days a month or more
     
    Within 1 month

    If available:
    • Neuroimaging report
     
    N/A

    Consultation letter
     
    Within 12 months

    Patient Demographics:
    • telephone number(s)
    • family doctor
    • address
     
    Current
    PATIENT APPOINTMENT INFORMATION
     
    MISSED APPOINTMENT GUIDELINES
    If a new patient misses the initial appointment, the referral will be closed, and the referring physician will be notified. Another referral will be required in order to rebook.
    If a new patient misses the initial appointment, the referral will be closed, and the referring physician will be notified. Another referral will be required in order to rebook.
     
    HOURS OF OPERATION
    Monday: 8:00 am - 4:00 pm
    Tuesday: 8:00 am - 4:00 pm
    Wednesday: 8:00 am - 4:00 pm
    Thursday: 8:00 am - 4:00 pm
    Friday: 8:00 am - 4:00 pm
       
     
    ADDRESS
    5 floor
    4448 Front Street SE
    Calgary Alberta
    T3M 1M4
    PATIENT APPOINTMENT INSTRUCTIONS
    Please consider the following instructions:
    • Bring your Alberta health care card and a piece of government issued photo ID.
    • Check in at reception 15 minutes prior to your scheduled appointment time.
    • You may bring a family member or significant other during your consultation.
    • Please make sure to have someone with you if you are unable to communicate in English.
    Please consider the following instructions:
    • Bring your Alberta health care card and a piece of government issued photo ID.
    • Check in at reception 15 minutes prior to your scheduled appointment time.
    • You may bring a family member or significant other during your consultation.
    • Please make sure to have someone with you if you are unable to communicate in English.
     
    DIRECTIONS
    SHC CHAMP is located in the main building, take the Outpatient elevators to the 5th floor, procced to area 5E for check-in.

    South Health Campus (SHC) is located in the southeast of Calgary. Take Deerfoot Trail to the Cranston Ave/Seton Blvd exit and head one block east on Seton Boulevard. South Health Campus will be on your right.

    For regular clinic visits, travel clockwise around the building to access underground parking and the main entrance. There is access to the Emergency Department entrance off of Seton Boulevard.

    Transit:
    Current bus service to South Health Campus (SHC) include:
    - Route 468 travels through Cranston, Seton, Auburn Bay and Mahogany. This bus drops off at the west stop on Seton Boulevard to the north of the campus.
    SHC CHAMP is located in the main building, take the Outpatient elevators to the 5th floor, procced to area 5E for check-in.

    South Health Campus (SHC) is located in the southeast of Calgary. Take Deerfoot Trail to the Cranston Ave/Seton Blvd exit and head one block east on Seton Boulevard. South Health Campus will be on your right.

    For regular clinic visits, travel clockwise around the building to access underground parking and the main entrance. There is access to the Emergency Department entrance off of Seton Boulevard.

    Transit:
    Current bus service to South Health Campus (SHC) include:
    - Route 468 travels through Cranston, Seton, Auburn Bay and Mahogany. This bus drops off at the west stop on Seton Boulevard to the north of the campus.
     
    PHONE
    403-956-3543
     
    PARKING INSTRUCTIONS
    Public parking is located in the underground parking Lot 1 on Level P1. You can get to that lot from the parkade entrances B (Forest) and C (Mountain). As well, Emergency Parking Lot 3 is available for public needing to access the Emergency Department.

    On the south side of SHC is free parking for two hours on Front Street, by the main entrance.
    Public parking is located in the underground parking Lot 1 on Level P1. You can get to that lot from the parkade entrances B (Forest) and C (Mountain). As well, Emergency Parking Lot 3 is available for public needing to access the Emergency Department.

    On the south side of SHC is free parking for two hours on Front Street, by the main entrance.
     
    EMAIL
    VIRTUAL APPOINTMENT INFORMATION
     
     
    WHEELCHAIR ACCESSIBILITY
    Yes

    This facility is wheelchair accessible.


    The primary purpose of the All Locations list is to let the user easily access any location of a healthcare service without going back to the main search screen.

    The locations listed have 3 background colors:
    • Green means the healthcare service@location has referral information attached to it.
    • Brown means the healthcare service@location never had referral information attached to it, or it has unpublished referral information.
    • Red means
      • IA changed the healthcare service@location's status to something other than Current
      • It was deleted if it is an ARD healthcare service@location.
    Green  and Brown are always at the top of the list. These are the Healthcare Service@Locations with the status of Current.
    The Red list at the bottom consists of non-current Healthcare Service@locations that once had Published referral information in the ARD.
    If the referral information was never published in ARD the Healthcare Service@location will not show in the Red list.

    The secondary purpose of the All Locations list is to allow ARD Administrators to recover (copy) referral information from the non-current Healthcare Service@Locations to ones that are current.

    Common Scenario:
    A Healthcare Service moves from one location to another. In this case the IA Healthcare Service@Location record will be made defunct (non-current) and a new Healthcare Service@Location record will be created with a current status. In this scenario the captured referral guidelines in ARD can become "orphaned" as they are not attached to any current IA healthcare service.

    Categories of non-current or orphaned referral guidelines: INDIVIDUAL and COMMON.
    The REFERRAL GUIDELINES section of the profile has the prefix INDIVIDUAL or COMMON to help you choose the method below when transferring referral guidelines from a non-current Healthcare Service@Location to a current healthcare service@location.

    Individual referral process
    1. Click on a non-current (Red) Healthcare Service@Location at the bottom of the All Locations list.
    2. The non-current referral info is displayed with the link Copy this Referral Process to another Healthcare Service@Location link on the upper right hand corner. Click on the copy link.
    3. Choose a current location (Green or Brown) from the All Locations list. This will be the Healthcare Service@Location you are pasting the referral info into.
    4. The system will display the Edit Referral Info screen populated with the referral info from the non-current Healthcare Service@Location you viewed in the first step.
    5. Click Save and the referral info is transferred from the non-current Healthcare Service@Location to the current one.
    6. Repeat these steps for each Healthcare Service@Location that needs attention.

    Common referral process - 2 sub cases.
    Case 1: At least 1 current Healthcare Service@Location with common referral info is with current status for this healthcare service; One or more Healthcare Healthcare Service@Locations where replaced by new one.
    1. Click on any current Healthcare Service@Location whether it has referral info (Green) or not (Brown).
    2. The healthcare service location opens in the Edit Referral Info screen populated with the current common referral info.
    3. Save it. 
    4. All locations will be updated with the common referral information, including all the locations that don't have referral info yet (Brown). The non-current referrals (Red) will also be updated.
    Case 2:  All Healthcare Healthcare Service@Locations for a healthcare service are set to a non-current status and replaced by new ones. In this case there is no current additional referral info to copy from, so the only alternative is to pick up the non-current common referral process (Red). Follow the steps described in the section Individual Referral Process above to copy/paste the non-current common referral info to the current healthcare service locations.
    Generally we want to replicate current common referral info to new or replaced healthcare service locations. We only resort to copying non-current common referral info if there is no other option.

    Remember: Some fields can be location specific with the common referral process:
    Parking Instructions, Directions, Parking Map, Wait Time, Referral Phone or Referral Fax.
    To update these items you have to edit each Healthcare Service@Location separately.

    ADDITONAL NOTES:
    • The info icon after the All Locations drop down will be visible to ARD Administrators.
    • The system doesn't allow you to copy referral information from one non-current Healthcare Service@Location to another.

     

    V6.6