Abstract Details

Title The Accuracy of the Diagnosis of Migraines and Prevalence of Prophylactic Care Prescribed

Topic Headache

Presentation(s) P11 - Poster Session 11 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-004

Objective To determine the accuracy that residents correctly diagnose migraine headaches; the frequency that level A and level B prophylactic treatment is prescribed for eligible patients; the growth of residents regarding these two variables over their three years of training in a traditional neurology residency.

Background Migraine headaches are a debilitating condition that are often times either not diagnosed or are misdiagnosed. Using the ICHD-3 guidelines, neurologists must correctly diagnose the type of migraine someone experiences to prescribe the proper preventative pharmacologic treatment rather than ineffective opioids or NAIDSs.

Design/Methods A chart review of 276 patients originally seen by a neurology resident between July 2017 and June 2018 was conducted at Temple University Hospital. Using notes written by residents, a diagnosis was determined based on ICHD-3 guidelines and the features of the migraines outlined in patient notes. A determination was made as to whether the patient could benefit from prophylactic treatment and then it was recorded what kind of medication (if any) that the patient received.

Results Of 276 patients, 57% received the correct diagnosis from the neurology resident. Looking into the level of residents, the correct diagnosis increased progressively from PGY2 residents with a 50% accuracy to PGY4 residents with a 68% accuracy. Of the 225 patients who qualified for prophylactic pharmacologic treatment, 10% did not receive any preventative treatment, while 52% were prescribed level A medicine, 22% level B, and 16% received other unrecommended preventative medications.

Conclusions

A large minority of patients are not receiving the correct diagnosis for their migraines even though senior residents are correctly diagnosing their patients at a significantly higher rate than junior residents. While most patients are receiving prophylactic treatments when needed, less than the majority are being prescribed level A medications outlined by AAN.

Authors/Disclosures
Joseph Sisti IV PRESENTER	No disclosure on file
Van Hellerslia, PharmD	No disclosure on file
Paul M. Katz, MD (Temple University Health System)	Dr. Katz has nothing to disclose.

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