Knowledge Bank

Introduction: Migraine is a debilitating neurological condition that affects millions of individuals worldwide. The American Headache Society has evidence-based guidelines on the use of intravenous (IV) medications for a condition known as status migrainosus (SM). Additionally, the literature on the utilization of telehealth services for migraine sufferers suggests improved access, satisfaction, and outcomes. Purpose: The primary purpose of this quality improvement project was to evaluate the implementation of follow-up telehealth visits by an advanced practice registered nurse (APRN) for patients receiving IV therapies for SM in an outpatient infusion center. Outcome measures included improvement in pain scores, need for secondary interventions, and patient satisfaction. Methods: A total of 36 patients presenting with SM were evaluated using a next day telehealth visit by an APRN to assess pre- and post- treatment pain scores using the numeric rating scale (NRS), as well as identifying the need for secondary interventions. A six question Likert scale survey was used to evaluate the project. The survey was administered to patients assessing their pain relief, acceptability of telehealth, access to care, patient satisfaction, and likelihood of visiting an Emergency Department if the infusion center was not available. Results: There was a statistically significant difference in pain scores from pre infusion to post infusion, and from pre infusion to 24 hours post infusion. There was no significant difference between post infusion pain scores and 24 hours post infusion pain scores. Thirty nine percent of patients needed either an additional infusion or another acute intervention. Patients were overall satisfied with the next day telehealth visit (4.7/5). Conclusions: Most patients presenting for SM in an outpatient infusion center received adequate pain relief. Although secondary interventions were needed, the telehealth visits were found to be well accepted, and treatment recommendations were clear.