Practice variation after implementation of a protocol for migraines in children

Area of Science:

• Pediatric Emergency Medicine
• Neurology
• Clinical Protocol Implementation

Background:

• Migraine is a common neurological disorder in children.
• Standardized treatment protocols can improve care in emergency settings.
• Evaluating treatment changes over time is crucial for evidence-based practice.

Purpose of the Study:

• To assess the impact of a migraine treatment protocol on care in a pediatric emergency department.
• To analyze changes in migraine treatment patterns over a 10-year period.
• To compare patient demographics and medication use before and after protocol implementation.

Main Methods:

• Comparative retrospective chart review of pediatric migraine patients.
• Two distinct 2-year study periods: 1996-1997 and 2006-2007.
• Analysis of treatment protocols implemented in 1999.

Main Results:

• Increased patient visits for migraine (144 vs. 182) and higher treatment rates (30% vs. 50%) in the later period.
• Significant variations observed in the types of medications used for pediatric migraine treatment.
• The 10-year study demonstrated a 20% increase in treated patients.

Conclusions:

• Implementation of a pediatric migraine treatment protocol led to observable changes in emergency department care.
• Treatment strategies for pediatric migraine evolved over the study period.
• Protocols can influence clinical practice patterns in pediatric emergency medicine.