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Sub-optimal treatment of paediatric migraine in an emergency department: An observational study

Sharon Klim1, David Krieser2,3, Anne-Maree Kelly1,4

  • 1Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|July 26, 2019
PubMed

Insights

Pediatric migraine treatment in Australian emergency departments (EDs) often lacks consistency with evidence-based guidelines. The study found concerningly high opiate use in children treated for migraines.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Clinical Pharmacology

Background:

  • Migraine is a common neurological disorder in children.
  • Effective management of pediatric migraine in emergency settings is crucial.
  • Current treatment patterns in Australian emergency departments (EDs) for pediatric migraine are not well-described.

Purpose of the Study:

  • To characterize the acute treatment of pediatric migraine in Australian EDs.
  • To compare ED treatment of pediatric migraine with existing evidence-based recommendations.

Main Methods:

  • Retrospective cohort study design.
  • Analysis of a planned substudy focusing on children presenting to an Australian ED with a final diagnosis of migraine.
  • Primary outcome was the treatment administered during the ED visit.

Main Results:

  • Thirty-five children diagnosed with migraine in the ED were included.
  • Commonly administered medications included non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, and ondansetron.
  • Specific antimigraine therapies were infrequently used, while 14% of children received opiate medication.

Conclusions:

  • Pediatric migraine treatment in the studied Australian EDs was inconsistent with evidence-based guidelines.
  • The utilization of opiates for pediatric migraine management in EDs is notably high and warrants concern.
Abstract

Keywords:
emergency departmentmigrainepaediatric

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