Patient-Centered Migraine Management

Migraineurs are people who suffer from migraine headaches— a widespread health condition which is considered to be one of the ten most disabling conditions in the world (WHO, 2012). Although migraine headaches are not typically life-threatening, they can cause significant levels of disability by producing incapacitating headache pain with a spectrum of associated symptoms including light and noise sensitivity, nausea and vomiting which can last anywhere from hours to weeks. This illness not only equates with high medical costs but it is also associated with a lost income adding up to a staggering $12 billion per year in the United States (Lafata et al., 2004). Despite advanced technology and new medications, migraine headaches continue to cause substantial disability. Scholars believe that going back to the basics and providing the foundational migraine knowledge and skills to patients will significantly reduce migraine headache infirmity by empowering migraineurs to take control and manage their migraine independently. The purpose of this study was to understand the perspectives of adult migraine patients and neurology providers at a Midwestern neurology clinic regarding migraine patient education. Furthermore, this study sought to develop a migraine patient education program that would provide the knowledge and skills necessary for patients to independently manage their migraine. This systems change project involved two phases, using cross-sectional survey designs. Phase I surveys solicited information and opinions from the stakeholders—the migraine patients and neurology providers regarding the current methods of migraine patient education. Phase II involved developing, implementing, and evaluating a Headache Management Plan which was the first attempt at the Midwestern neurology clinic to provide a migraine patient education program which was patient-centered and evidence-based using stakeholder input. Phase II survey results from both migraine patients and neurology providers were overwhelmingly positive with regard to participants being able to understand the Headache Management Plan, allowing patients’ to be more actively involved in the planning of their treatment, providing the knowledge and skills to better manage migraine at home, and the rating of the overall experience with the Headache Management Plan. Although the findings of this pilot study were very optimistic, the study was limited by marginal migraine patient survey responses in Phase I and a small sample size in Phase II of the trial with minimal representation of diverse populations. Thus, generalization of these conclusions could not be made to all adult migraine patient populations in the neurology clinic. Future studies are needed to further evaluate the method and content of this migraine patient education quality improvement initiative