OUCH: Overcoming Uncontrolled Chronic Migraine Headaches

Migraines are a common type of primary headache that affects over 36 million people in the United States and one billion people worldwide. While oral preventative treatments have been considered first-line therapy for chronic migraines, anti-calcitonin gene-related peptide monoclonal antibodies have recently emerged as an effective treatment option. The purpose of this quality improvement project was to improve the therapy adherence and quality of life outcomes for patients with chronic migraines by facilitating a transition from oral migraine prevention therapy to treatment with an anti-calcitonin gene-related peptide monoclonal antibody agent. This project was developed utilizing the Focus, Analyze, Develop, and Execute QI model. The results of a ten-day reflective practice activity revealed poor patient adherence with oral migraine preventative therapy due to the intolerability of adverse effects. The clinical practice change was implemented with qualifying patients over six weeks utilizing Lewin’s change theory as the translational framework. The primary endpoint of this project was an improvement in treatment adherence, reductions in the number of migraine days per month by 50% or more, and improvements in the patients’ quality of life with better migraine control and fewer adverse treatment effects