What role do urgent care centers play in headache management? A quality improvement study of select urgent care facilities

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Conference Proceeding

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Objective: To conduct a survey of urgent care (UC) centers to determine the type of care available for patients presenting with a chief complaint of acute headache.

Background: Migraine affects more than 40 million Americans. Patients with acute migraine often seek urgent medical care to treat pain and associated symptoms that do not respond to therapeutic options at home. It is estimated that the majority of visits to the Emergency Department (ED) for headache can be accounted for by migraine patients. UC centers may be more suitable for evaluation and treatment of such patients. There is little data on how headache is evaluated in UC settings and what types of treatments are available.

Design/Methods: Information was collected via a cross-sectional survey, including UC staffing (e.g. number and backgrounds of staff, hours of operation), average length of UC visits for headache, treatments and tests available for patients presenting with headache, and disposition including to the ED.

Results: A total of 10 UC programs (which included 61 UC sites) were surveyed. The vast majority (8/10; 80%) had diagnostic testing onsite for headache evaluation. A small majority (6/10; 60%) had the American Headache Society recommended intravenous medications for acute migraine available. Half (5/10) had a headache protocol in place. The majority (6/10; 60%) had no follow up policy after UC discharge.

Conclusions: UC centers have the potential to provide expedited, affordable and cost-effective care for patients presenting for the evaluation and treatment of headache. However, considerable variability exists amongst UCs in their clinical approach to acute headaches. More studies are needed, along with the development of protocols and professional partnerships to help guide the evaluation, triage, and treatment of patients with acute headache in UC settings.



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