The Quality of Headache Treatment in The United States: Review and Analysis of Recent Data

Abstract

The methods and results of a recent large study of the quality of health care in the United States are reviewed with special emphasis on findings specific to headache care. The study's implications for educational and quality improvement efforts in the headache field are considered. These include (i) the need to teach and reinforce fundamental history-taking and physical-examination processes at all levels of medical education; (ii) the importance of recognizing serious problems of underuse and misuse of proven evaluation and treatment technologies; (iii) the desirability of shifting educational resources from simple messages that have been adequately absorbed toward more nuanced and targeted educational goals; and (iv) the value of novel and unorthodox educational strategies. Professional headache societies need to devote considerable resources to address the problem of widespread and important deficiencies in simple, fundamental care processes for headache.

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“…This is apparent when one recognizes that triptans, while considered the "gold standard" of migraine treatment, are not increasing in utilization by the migraine population. 16,17 Reality dictates that patients are seeking more than triptans alone provide. Understanding this "adherence gap" represents the distance between evidence-based medicine and patient-centered care.…”

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