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Measure purpose: To optimally treat cluster headache

The numerator: Patients who were prescribed short-term and/or long-term preventive treatment, including treatments prescribed by a different clinician once during the measurement period

is divided by

The denominator: Patients > 18 years of age with a diagnosis of cluster headache

Exclusions are removed from the denominator for:

• Guideline recommended treatment is medically contraindicated or ineffective for the patient
• Patient reports no CH attacks within the past 12 months or is not in an active attack period
• Provider determined attack frequency does not warrant preventive treatment 
• CH are sufficiently controlled with over the counter medications
• Patient and/or caregiver decline
• Lack of insurance or insurance coverage for treatment prescribed

Key phrases

Examples of key phrases you could use to meet the measure include:

• Preventive treatment prescribed
• Occipital nerve injection with steroid prescribed
• Verapamil prescribed

Measure calculation example

Dr. John had 50 patients over the age of 18 with a diagnosis of cluster headache between January 1 and December 31. This is the denominator. Two patients had a contraindication, two patients had their CH controlled with over the counter medications, and one patient declined therapy. These five (2+2+1) patients are removed from the denominator.

Of the remaining 45 patients, 22 were prescribed a preventive treatment. This is the numerator.

Quality of care =22/(50-5). Dr. John has a score of 48% for this measure.