Key takeaways:
- Sufferers with headache can face important limitations of time and distance for medical care.
- Implementation of a headache template elevated documentation, boosted confidence.
MINNEAPOLIS — An evidence-based administration software embedded inside digital well being information of sufferers with headache in a northern New England major care setting led to elevated documentation and doctor confidence.
“Since we’re set in Vermont, we wish to attempt to shut the hole between major care and the wait to be seen for a neurologist,” Makayla Fikrat, DNP, APRN, FNP-C, a doctoral scholar on the College of Vermont, informed Healio on the American Headache Society Annual Scientific Assembly. “
“In Vermont, in 2022, it was a 114-day wait to be seen by a neurologist,” Fikrat stated. “I occur to know that’s elevated as much as a couple of yr, just a little over a yr and a few change.”Rural areas of Vermont are sparsely populated, with neurology care concentrated within the populated northwestern a part of the state.
With these wait instances reflecting the dearth of neurologists in rural areas, the researchers needed to ensure “that the affected person inhabitants has excellent care whereas they’re ready for that and even, if higher, simply be absolutely taken care of on the major care degree,” she stated.
“It’s fairly a trek to stand up to the massive college the place we’re,” Fikrat stated. “Lots of challenges there.”
Fikrat and colleagues sought to streamline info lag and enhance therapy by implementing a template and offering American Headache Society-based training for major care physicians, which supplied a extra complete file of headache signs and incidence.
Their examine, carried out in three phases from mid-2024 to December 2024, was centered at a scholar well being clinic on the College of Vermont that employed 12 major care suppliers.
The primary part featured casual wants assessments and supplier focus teams that added evidence-based claims resembling headache frequency and way of life modification components to an already-existing template.
“We mainly made a piece the place the supplier might ask the affected person in the event that they’re getting good sleep, in the event that they’re ingesting sufficient water, if their stress is properly managed,” Fikrat stated. “We additionally introduced in a bunch of interventions from the Affiliation of Migraine Problems.”
Fikrat famous that these interventions included good prescribing references from suppliers, which they discovered probably the most useful.
The 12-week-long second part included knowledge assortment forward of a Likert scale-scored supplier survey that requested suppliers about their confidence in managing headache issues in addition to their chance of documenting headache frequency and counseling sufferers on modifiable way of life components.
The second part additionally included the “reside” part of the up to date template, a file of supplier assets together with an hour-long supplier academic session with American Headache Society supplies, known as “First contact: Headache in major care.”
The ultimate part included post-survey knowledge assortment, together with repeated questions on confidence in headache administration, documentation and counseling, and chart audits.
The researchers reported 51% template utilization throughout 69 headache visits to the clinic over the 12-week intervention, with headache frequency documentation rising with documentation prompting from 17.6% to 34.2%.Headache template % utilization elevated from 41.7% in September 2024 to 70.37% in October 2024, earlier than falling to 40% in November after which 33.3% in December.
Information additionally confirmed will increase within the imply common response within the surveys issued earlier than and after the supplier intervention on confidence in managing headache (3.3 to 4.3); chance of counseling sufferers on way of life modifications (4.6 to 4.9) and chance of documenting affected person headache frequency (4 to 4.6).
General, supplier confidence elevated by 30%, with a 6.5% enhance within the chance that suppliers will counsel sufferers about modifiable way of life components and a 15% enhance within the chance that they may doc headache frequency.
“I feel probably the most influential issues was the headache frequency documentation that we embedded into the template as a result of that really nearly doubled with prompting,” Fikrat famous. “In order that signifies that suppliers had been documenting simply with one easy addition to their template.”
For extra info:
Makayla Fikrat, DNP, APRN, FNP-C, can be reached at neurology@healio.com.
