Evidence-based medicine largely underutilized in pediatric headache, migraine

  • Cephalalgia

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Just 16.1% of pediatric patients presenting to the emergency department (ED) or a clinician with complaints of suspected migraine or primary headache received a prescription consistent with evidence-based medicine (EBM), and 46.0% received no medication at all.
  • 1 of every 6 patients who received a prescription received an opioid or barbiturate.

Why this matters

  • 45.7% of patients who reported headache symptoms received no headache or migraine diagnosis.

Study design

  • Retrospective study using data from electronic health record between 2008 and 2014 to evaluate encounters between 38,926 children and adolescents (aged, 6-17 years) with migraine or primary headache and 1617 providers.
  • Funding: Migraine Research Foundation.

Key results

  • 17.7% and 36.6% of patients were diagnosed with migraine, headache, respectively.
  • Only 16.1% patients received EBM, whereas 46.0% patients did not receive any medications.
    • Older children (OR, 1.07/year of age; P<.001 females p and those diagnosed with migraine had higher odds of receiving ebm.>
  • Among patients who received a prescription, 15.8% received an opioid or barbiturate.
    • Being older (OR, 1.14/year of age; P<.001 female p or cared for in ed care increased the risk.>

Limitations

  • Only initial visit to a single large health system in the Midwest studied.

Coauthored with Antara Ghosh, PhD

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit