The Migraine Toolkit for Primary Care (MTPC) was a multi-pronged quality improvement DNP project implemented at a large primary care clinic in Portland, OR. 

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This was done using a dual approach: a provider-focused arm and a patient-focused arm.

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In the provider-focused arm, PCPs initially completed a knowledge survey assessing their understanding of migraine management, including diagnosis, treatment, and current guidelines. This was followed by a 30-minute educational in-service, after which PCPs received a laminated one-pager summarizing key aspects of current migraine science and guideline-based standards of care. A follow-up survey, administered four months post-intervention, evaluated the in-service's efficacy and the retention of knowledge among PCPs. The goal for this arm was for participating PCPs to demonstrate a 25% increase in knowledge of current migraine science, confidence in managing migraine disease, and understanding of guideline-based standards. This was measured by pre- and post-intervention survey comparisons.

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The patient-focused arm involved developing and distributing educational brochures for patients and implementing the ID Migraine screening tool and the HIT-6 assessment. These tools were integrated into the clinic’s electronic health record (EHR) system. Medical assistants were trained to administer these tools to patients presenting with any headache complaints. The objective for this component was for 80% of patients with migraine to undergo the HIT-6 assessment. For those returning within the data collection period, the goal was for a functionally significant improvement in their overall headache burden, defined as a decrease of 5 or more points on their HIT-6 scores.

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All components of the MTPC can be found below.