Quality improvement in neurology: Primary headache quality measures

Headache and migraine are common, debilitating, and costly. Headaches are among the most prevalent neurologic disorders. In US studies, somewhere between 12% and 23% of adults over the age of 18 have had a migraine headache in the past 3 months.1 In fact, the WHO ranks migraine headache in the top 20 of the world's most disabling medical illnesses.2 Frequent headache or migraine can significantly and negatively impact an individual's quality of life, family interactions, and ability to work.3,4 Hawkins et al.5 found that nationally, migraine-associated expenditures include outpatient care costs of $5.21 billion; prescription costs of $4.61 billion; inpatient care costs of $0.73 billion; and emergency department care costs of $0.52 billion. At work, people with migraine have higher levels of lost productivity and reduced performance, and more absences from work.6