Berks County Medical Society Medical Record Fall 2017 - 22

rhs Student Sum mer Research Projects
Reading Health System Migraine Headache
Population Assessment to Determine Care
Quality and Resource Allocation
by Haley Powell, OMS-II; Lauren Chamberlain, OMS-IV; Richard Lukose, DO
The Reading Hospital, Section of Neurology
Introduction: Migraine headaches are a major problem and are
considered the eighth most disabling medical condition in the
United States. Suffering from such a debilitating chronic disorder
can lead to additional comorbidities, mental health ailments,
economic burdens, and a substantial decrease in quality of life.
This project is the first step in a multidimensional quality
improvement activity to help the Reading Health System (RHS)
design strategies to optimize care for the migraine sufferer. Our
initial effort was to obtain baseline demographic and clinical
information regarding patients seen within the RHS Emergency
Care Unit with a complaint of headache.
Research Methods: We conducted concurrent and retrospective
chart reviews of men, women, and children of all ages presenting
to the ED with a severe headache. Potential subjects were selected
based upon review of their current visit and chart history by means
of Epic electronic medical record. A standardized questionnaire was
administered, including patient demographics, characteristics of
the patient's headache, and approach to therapy. Potential subjects
who were unable to be interviewed in person were called within the
following three days and interviews were conducted via telephone
Data analysis was descriptive. Comparisons were made between
our population and that found in select peer-reviewed articles.
Results: 139 patients who received care in the RHS ED were
interviewed. We found that patients presenting to RHS with a
complaint of headache ranged from age 10-81 years, with the
majority (62%) being females between 21-50 years old. 47% of
subjects contacted a medical provider and were instructed to go to

the ED. 36% were using prescription rescue medications and nearly
half reported using over-the-counter medications. Prophylactic
prescription headache strategies were utilized by 36% of those
surveyed. Of the migraineurs who met status for chronic migraine,
25% are managed by a neurologist and 28% are managed by their
primary care physician. 19% are using prescription prophylactic
treatments, and 25% are using appropriate prescription rescue
medications.
Of the 47 participants surveyed, 31 met diagnostic criteria for
chronic migraine or considered themselves chronic migraineurs. Of
those 31 participants, 71% and 74% of these patients suffered from
anxiety and depression, respectively. 55% reported sleeping issues
such as insomnia and sleep apnea.
Conclusions: This initial descriptive study explored characteristics
of headache sufferers who were seen in the RHS ED. Initial findings
suggest potential approaches to improve management, especially
in the area of behavioral interventions. Next steps include the
expansion of the survey to other sites, followed by the development
of a broader quality improvement strategy for intervention and
analysis.

Haley Powell is a second-year student at the
Alabama College of Osteopathic Medicine. She
earned a B.S. in Exercise Science from Florida
State University in Tallahassee, FL, where she
served a year as VP of the American Medical
Student Association at FSU.
PA ACADEMY OF FAMILY PHYSICIANS, READING
HEALTH/TOWER HEALTH SYSTEM AND CARON
FOUNDATION JOIN TOGETHER TO BRING AN
OUTSTANDING CME PROGRAM TO BERKS COUNTY
DATE: NOVERMBER17-19, 2017
LOCATION: DOUBLETREE HOTEL IN READING
WHAT: AFFORDABLE CME PLUS KNOWLEDGE
SELF-ASSESSMENT STUDY GROUP (KSA)
WHAT ELSE: SOCIAL EVENTS WITH FAMILY MEDICINE
COLLEAGUES FROM AROUND PA
REGISTRATION AT: WWW.PAFP.COM/CME

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Berks County Medical Society Medical Record Fall 2017

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