Community Health Worker Integration into Migraine Care: A Model for Scalable Migraine Screening
Medha Tandon1, Olivia Begasse De Dhaem2, John Galdo3, Richard Logan4, Courtney Hahs4, Kelsey Holder4, Amaal Starling1
1Mayo Clinic, 2Institute for Headache and Brain Health, 3CPESN Health Community Health, 4L&S Pharmacy
Objective:
Explore using community health worker (CHW) expertise for migraine screening in the community and triage level of care.
Background:
CHWs are trained individuals acting as public health liaisons to improve the overall community health. Several medical societies have identified their importance and utilized their expertise for screening, testing and referrals of appropriate patients.
Despite advances in care, the overall prevalence and burden of migraine has remained unchanged over the last few decades. In the OVERCOME (US) 2018 cohort study, only 51% of respondents with migraine had a migraine consultation within the past year. This lack of progress highlights the need for early identification and management of this disease in the community.
Design/Methods:
This is a retrospective chart review of data from a pharmacy-based quality improvement service. Pharmacy-based CHWs screened consecutive community members for migraine using the ID migraine and estimated the migraine-related lost productive time (LPT) at work, which was calculated as the days missed work + 0.5 x (number of days with reduced productivity by at least half). R version 4.4.0 was used for statistical analysis.
Results:
CHWs screened 137 individuals (38 men and 93 women) with an average age of 67.9. Of these, 39 (28.5%) individuals had headaches. Of those who had a headache, 12 individuals (30.7%) screened positive for migraine, and 5 (41.7%) of those did not have a prior headache diagnosis. Two individuals (13%) reported reduced productivity at work due to headaches. Only 8 (46%) of individuals with diagnosed migraine were prescribed medications.
Conclusions:
CHW screening was able to successfully identify individuals who screened positively on ID-Migraine without a previous headache diagnosis and individuals with an established diagnosis who were not receiving treatment. Integration of CHWs into migraine care can identify individuals with migraine who require access to headache care. Further studies are needed to assess scalability of this approach.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.