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Published on: June 2, 2014

Effectiveness of standardized combination therapy for migraine treatment in the pediatric emergency department

Stephanie Leung1, Blake Bulloch, Christine Young

  • 1Phoenix Children's Hospital, Phoenix, AZ 85016, USA.

Headache
|February 15, 2013
PubMed

Insights

Standardized intravenous therapy significantly reduced pain and emergency department (ED) stays for pediatric migraine patients. This approach improved outcomes compared to non-standardized treatments, lowering hospital admission rates.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Clinical Therapeutics

Background:

  • Migraine headaches account for a significant portion of pediatric emergency department visits (8-18%).
  • Current acute pediatric migraine treatment lacks standardization, leading to variable patient outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of a standardized intravenous combination therapy for acute pediatric migraine.
  • To compare treatment outcomes before and after implementing a consistent therapeutic regimen in a pediatric emergency department.

Main Methods:

  • Retrospective chart review of pediatric migraine patients treated between August 2006 and March 2010.
  • Comparison of outcomes between patients receiving non-standardized therapy and those treated with a standardized regimen (normal saline, ketorolac, prochlorperazine, diphenhydramine).
  • Primary outcome: reduction in headache pain score; secondary outcomes: ED length of stay, hospital admission, and 48-hour readmission rates.

Main Results:

  • Standardized therapy (87 patients) showed significant reductions in headache pain scores compared to non-standardized therapy (165 patients) (decrease of 6.9 vs. 5.3).
  • Patients receiving standardized treatment experienced shorter emergency department stays (4.4 vs. 5.3 hours).
  • Hospital admission rates were significantly lower in the standardized therapy group (3% vs. 32%).

Conclusions:

  • A standardized intravenous combination therapy is effective for managing acute pediatric migraines in the emergency department.
  • This standardized approach significantly improves pain management, reduces healthcare resource utilization (ED stay, hospital admission), and enhances patient care.
Abstract

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