Increasing Access to Headache Care by Integrating Primary Care Clinical Pharmacy Providers ( PCCPP) at a Headache Center of Excellence
Lipika Nayak1
1San Antonio VA Medical Center
Objective:

To assess the impact of integrating PCCPP to help primary care providers with management of primary migraine or primary tension type headaches on patient’s access to headache care, clinical management, and care outcomes at the San Antonio VA HCoE.

Background:

Limited access to specialized headache care remains a major barrier to effective management, leading to delays in diagnosis, suboptimal treatment, and poor patient satisfaction. Incorporating PCCPP into a multidisciplinary ( MDC) team may improve access, continuity of care, medication optimization and streamline neurology referrals thus allowing more efficient use of headache specialty services for patients with common primary headache disorders.

Design/Methods:

A retrospective quality improvement project was conducted from January to June 2025 and compared with data from January to June 2024. PCCPP collaborated with PCP and HCoE under a renewed collaborative service agreement to manage medication regimens, monitor treatment response, provide patient education and quickly refer back to PCP or HCoE, if headache nature or character changes. Data were analyzed for appointment access, medication optimization and subspeciality referrals.

Results:
 When results were compared from 2024, implementation of above model lead to 10% reduction of neurology referrals, reduced wait time for HCoE providers, increased CGRP antagonist initiation of19.07 % by PCP and 6.99% by PCCPP, increased headache encounters by PCP was 57.06% and by PCCPP was7.46%. Community referrals went down from 49% to 36% in first 3 months of implementation. 
Conclusions:

Integration of PCCPP into MDC model significantly improved access and quality of headache care. This collaborative approach may serve as a scalable framework for improving headache management across healthcare systems.

10.1212/WNL.0000000000217615
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.