Towards patient self-care in headache: analysis of a Sláintecare headache service

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 94; no. Suppl 1; p. A23
• Main Authors: McGettigan, Jamie, McGuirk Edel, Pilladath Merlin, Bradley, Maeve, Hutchinson Siobhán
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.11.2023
• Subjects: Headaches; Quality improvement
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/JNNP-2023-ABN.68

In Ireland, 21,000 people are waiting for a Neurology outpatient appointment with up to 30% referred for headache. It is a common presentation to ED (7th) and AMAU (2nd). In response, the Sláintecare Inte- gration Fund helped create headache clinics to support patient self-care in headache.We present an analysis of the headache service pathway at St James’s Hospital (SJH). Using data collected from SJH electronic records, OPD lists, and ED admission lists, we statistically analyse the referral sources, diagnoses, management outcomes, and discharge rates of OPD encounters from May – October in 2021 (n=211) versus 2022 (n=269). Overall, 85.1% of referrals were seen within 6 months and 11.7% within 1 month. New patients comprised 75% of clinic attendances. Migraine was the most common diagnosis (74.5%). A significantly greater proportion of discharges occurred in 2022 (25.3% vs 11.4%, p=<0.001). The service data manager referred 9.3% (n=25) of patients in the 2022 period via manual ED presentation analysis.We examine our pathway and the role of the service within a busy inner-city hospital using graphical representation. Successes & challenges thus far are addressed. Future quality improvement measures are discussed. We envision this analysis as the beginning of an ongoing quality improvement cycle.