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Modifiable Lifestyle and Chronification Factors Counseling for Migraine

Measure Purpose: Comprehensive management of migraine

The numerator: Documentation that the patient was counseled on at least 1 modifiable lifestyle or chronification factor^ once during the measurement period

^Modifiable lifestyle and chronification factors include:

  • Irregular or skipping of meals
  • Excessive or irregular caffeine consumption
  • Exercise
  • Smoking
  • Stress management
  • Restorative sleep 
  • Adequate hydration
  • Other issues identified by the clinician or patient
  • Trigger identification and avoidance
  • Acute medication overuse

is divided by

The denominator: Patients > 6 years of age diagnosed with migraine

Exclusions are removed from the denominator for: 

  • Patient and/or caregiver decline counseling

Key Phrases

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

  • Counseled on excessive or irregular caffeine consumption
  • Counseled on acute medication overuse
  • Counseled on adequate hydration

Measure Calculation Example

Dr. Harrison had 100 patients over the age of 6 with a diagnosis of migraine between January 1 and December 31. This is the denominator. Nine patients declined counseling. These nine patients are removed from the denominator.

Of the remaining 91 patients, 33 were counseled on at least 1 modifiable or chronification factor. This is the numerator.

Quality of care = 33/(100-9). Dr. Harrison has a score of 36% for this measure.