• Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of headache. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2009 Mar. 76 p. [141 references]

Does not apply to this measure

This measure is used to assess the percentage of migraineurs who have documentation in the medical record that they have received written educational materials on migraines at a clinic/office visit.

The priority aim addressed by this measure is to increase education for patients with primary headache.

Migraine; patient education; written educational materials

All patients age 12 years and older who had an encounter with a primary care provider in the past month for migraine headache

Number of medical records with documentation of receiving written educational materials about migraine (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age greater than or equal to 12 years

Either male or female

Unspecified

Migraine is the most common headache disorder seen by primary care providers.

See also the "Burden of Illness" field.

Unspecified

Migraine headaches affect an estimated 23 million Americans, with 11 million experiencing significant headache-related disabilities. Migraine headaches also have an economic impact through significant losses in productivity as well as through health care costs.

• Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of headache: executive summary. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2009 Mar. 1 p.

Unspecified

See the "Burden of Illness" field.

Living with Illness

Effectiveness
Patient-centeredness

Users of care only

Patients age 12 years and older with diagnosis of migraine headache

A chart abstraction is conducted to determine if there is evidence that a clinician provided education about migraines.

Suggested data collection time frame is monthly.

Patients associated with provider

Inclusions
All patients age 12 years and older who had an encounter with a primary care provider in the past month for migraine headache

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Clinical Condition
Encounter

Time window is a single point in time

Inclusions
Number of medical records with documentation* of receiving written educational materials about migraine

*Documentation is defined as any evidence in the medical record that written educational materials were provided to the patient about migraine and lifestyle management. This can include information about:

• Genetic predisposition to migraine
• Role of lifestyle changes
• Stress reduction, regular eating and sleeping schedules, and regular aerobic exercise
• Results of overuse of analgesics and acute migraine drugs
• Benefit of keeping a headache diary
• Treatment approaches

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Encounter or point in time

Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of migraineurs who have documentation in the medical record that they have received written educational materials on migraines at a clinic/office visit.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne, and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: John Beithon, MD (Work Group Leader) (Lakeview Clinic) (Family Medicine); Chris Hult, MD (HealthPartners Medical Group and Regions Hospital) (Family Medicine); Mark Liebow, MD (Mayo Clinic) (Internal Medicine); Jerry Swanson, MD (Mayo Clinic) (Neurology); Frederick Taylor, MD (Park Nicollet Health Services) (Neurology); Linda Linbo, RN (Mayo Clinic) (Nursing); Jane Schmidt, NP (Allina Medical Clinic) (Nursing); Mary Gallenberg, MD (Mayo Clinic) (Gynecology); Pamela Kildahl, RPh (HealthPartners Medical Group and Regions Hospital) (Pharmacy); Joann Foreman, RN (Institute for Clinical Systems Improvement) (Facilitator); Teresa Hunteman, MA, CPHQ (Institute for Clinical Systems Improvement) (Facilitator)

ICSI has adopted a policy of transparency, disclosing potential conflict and competing interests of all individuals who participate in the development, revision and approval of ICSI documents (guidelines, order sets and protocols). This applies to all work groups (guidelines, order sets and protocols) and committees (Committee on Evidence-Based Practice, Cardiovascular Steering Committee, Women's Health Steering Committee, Preventive & Health Maintenance Steering Committee and Respiratory Steering Committee).

Participants must disclose any potential conflict and competing interests they or their dependents (spouse, dependent children, or others claimed as dependents) may have with any organization with commercial, proprietary, or political interests relevant to the topics covered by ICSI documents. Such disclosures will be shared with all individuals who prepare, review and approve ICSI documents.

John Beithon, MD jointly owns stock through a family member's employee benefit option.

Frederick Taylor, MD has participated and received remuneration as an Advisory Board member for GlaxosmithKline and Merck. He received speaker's fees and associated expense compensation for Speaker's Bureau participation for GlaxoSmithKline, Merck and Endo Pharmaceuticals. He has also received honorarium from Current Medicine for editorship of Current Pain and Headache Reports for 2008 and 2009. Additionally, he receives authorship content fees from Up to Date.

Jerry Swanson, MD has received royalties from Up To Date.

No other work group members have potential conflicts of interest to disclose.

Measure was not adapted from another source.

2003 Jul

2009 Jan

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of headache. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Jan. 59 p.

• Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of headache. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2009 Mar. 76 p. [141 references]

This NQMC summary was completed by ECRI on April 28, 2004. This summary was updated by ECRI Institute on January 31, 2005, February 27, 2006, September 25, 2007, and again on June 22, 2009.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.