Quality improvement in neurology

Quality improvement in neurologyPrimary headache quality measures Headache and migraine are common, debilitating, and costly.Headaches are among the most prevalent neurologic disorders.In US studies, somewhere between 12% and 23% of adults over the age of 18 have had a migraine headache in the past 3 months.1 In fact, the WHO ranks migraine headache in the top 20 of the world's most disabling medical illnesses.2 Frequent headache or migraine can significantly and negatively impact an individual's quality of life, family interactions, and ability to work.3,4 Hawkins et al. 5 found that nationally, migraine-associated expenditures include outpatient care costs of $5.21 billion; prescription costs of $4.61 billion; inpatient care costs of $0.73 billion; and emergency department care costs of $0.52 billion.At work, people with migraine have higher levels of lost productivity and reduced performance, and more absences from work.6 In 2013, the American Academy of Neurology (AAN) formed a multidisciplinary headache measurement workgroup (HMWG) to identify and define quality measures aimed at improving care delivery and outcomes for patients with headache and migraine.The HMWG represented academic institutions, national health care providers, and advocacy organizations concerned with the care of patients with headache.The AAN led this effort, facilitated the process, and convened the meetings.The American Academy of Family Physicians and the American Medical Association (AMA)-convened Physician Consortium for Performance Improvement (PCPI) also partnered with the AAN and nominated representatives and attended the HMWG meeting.The details of the full AAN measure development process are available online.7 The AAN headache quality measurement set could support quality improvement initiatives, public reporting, payment for quality, and maintenance of certification. OPPORTUNITIES FOR IMPROVEMENTBased on the literature, there are several gaps in the quality of care for people with headache and migraine.