- Emergency department (ED) patients who received opioids for migraine or headache had a longer median ED length of stay (LOS), were more likely to return to the ED within 30 days, and had higher admission rates than patients who did not receive opioids.
- The use of an opioid-free headache and migraine treatment algorithm was associated with a decrease in ED revisit rates, opioid administration, and opioid prescriptions provided at discharge.
Why this matters
- Studies suggest the use of opioids in EDs to treat headache or migraine is increasing, even though American Academy of Neurology and American Headache Society guidelines recommend against the treatment.
- 2953 patients with headache/migraine visited ED.
- 1614 patients visited ED before opioid-free headache and migraine treatment algorithm implementation.
- Funding: None.
- Patients in the post- vs prealgorithm group had lower incidence of:
- ED revisits within 30 days (6.3% vs 8.2%; P=.049),
- overall ED revisits (9.2% vs 12.1%; P=.014),
- opioid administration in the ED (5.2% vs 16.5%; P<.001 and>
- opioid prescriptions at discharge (2.2% vs 7.2%; P<.001>
- ED revisit rate within 30 days (15.2% vs 6.3%; P<.001>
- admission rate (12.2% vs 3.2%; P<.001 and>
- ED LOS (median, 182 vs 216 minutes; P<.001>
- Retrospective design.
Coauthored with Antara Ghosh, PhD