Date of Publication
2025
Project Team
Makayla M Fikrat RN, Erin Leighton DNP, APRN, FNP-BC, Dan Gookin MS, PT
Abstract
Chronic headache disorders are highly prevalent in primary care, yet underdiagnosed and undertreated. Effective management, including early use of preventative and cost-effective treatment, improves outcomes and reduces financial burden. The absence of headache management tools and decreased confidence put primary care providers at risk for ordering premature neurology referrals, without practicing to their full scope and contributing to a significant practice gap in headache medicine. The purpose of this quality improvement (QI) project was to improve utilization of evidence-based practice (EBP) materials for complex headaches in a student health primary care clinic in New England. A secondary aim focused on improving provider confidence in the management of complex headache disorders. A one-hour educational session was held using a slide deck provided by the American Headache Society’s “first contact” initiative for primary care providers. An electronic health record (EHR) template was updated to include EBP features, and prescribing guides were distributed. Pre- and post-intervention surveys were conducted to evaluate perceived effectiveness. A retrospective chart review was performed 12 weeks post-intervention. Providers reported 15 percent increase in documenting headache frequency, 6.5 percent increase in lifestyle counseling, and 30 percent boost in confidence in managing complex headache disorders. Template usage was 51 percent for all headache visits during the 12-week period. Practice updates and prescribing tools improved provider confidence and perception of EBP adherence. Template usage increased documentation rates, suggesting that EHR prompting may improve outcomes. Future research on integrating multifactorial approaches into education models for primary care is needed to assess the impact of ongoing headache management QI efforts.
Document Type
Dissertation/Thesis
Recommended Citation
Fikrat, Makayla M. RN and Leighton, Erin DNP, APRN, FNP-BC, "Optimizing Headache Management in Primary Care: An Evidence-Based Quality Improvement Plan" (2025). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 184.
https://scholarworks.uvm.edu/cnhsdnp/184
