Assessing evidence-based medicine and opioid/barbiturate as first-line acute treatment of pediatric migraine and primary headache: A retrospective observational study of health systems data

Cephalalgia : an International Journal of Headache
Elizabeth K SengRobert A Nicholson

Abstract

To evaluate providers' use and predictors of evidence-based medicine or opioid/barbiturate as first-line acute treatment for children's initial presentation of acute migraine or primary headache. This retrospective, observational study utilized patient (children ages 6-17) and provider/encounter characteristics extracted from the patient's Electronic Health Record from 2008-2014 during an initial encounter for migraine or primary headache. The primary outcome was provider evidence-based medicine utilization; overall prescriptions and opioid/barbiturate prescriptions were also evaluated. Hierarchical linear modeling examined whether Level 1 (patient: Demographic, insurance type) and Level 2 (provider/encounter: Treatment setting/location, encounter diagnoses) characteristics influenced outcomes. In all, 38,926 patients (56.7% female, mean age = 12.1) and 1617 providers were evaluated. Only 17.7% of patients were diagnosed with migraine; 16.1% received evidence-based medicine. Older children (OR = 1.07, p < 0.001), females (OR = 1.14, p < 0.001), and those diagnosed with migraine (OR = 4.71, p < 0.001) were more likely to receive evidence-based medicine. Among prescriptions, 15.8% were for opioids/barbiturates. Older children (OR...Continue Reading

References

Sep 24, 1994·BMJ : British Medical Journal·I Abu-Arefeh, G Russell
Jan 20, 2004·Cephalalgia : an International Journal of Headache·S W PowersA D Hershey
Feb 3, 2005·Pediatrics·Angela Roth-IsigkeitPeter Schmucker
Jul 16, 2005·Pediatric Annals·Donald W LewisMichael Sowell
Aug 3, 2007·Pediatrics·Donald W LewisUNKNOWN Adolescent Migraine Steering Committee
May 3, 2008·Current Opinion in Neurology·Paul Winner
Sep 19, 2008·Cephalalgia : an International Journal of Headache·D Kernick, J Campbell
Nov 8, 2008·The AAPS Journal·Emily O Dumas, Gary M Pollack
Feb 24, 2009·Pain·Marcelo E Bigal, Richard B Lipton
Sep 9, 2009·Cephalalgia : an International Journal of Headache·H-C DienerS J Greenberg
Aug 18, 2010·Cephalalgia : an International Journal of Headache·T W VictorR B Lipton
May 11, 2012·Headache·Stewart J Tepper
May 16, 2012·Pediatrics·Frederick J DerosierM Chris Runken
Oct 4, 2012·The Journal of Pain : Official Journal of the American Pain Society·Douglas C McDonaldDavid Izrael
Nov 26, 2013·Headache·Elizabeth LoderUNKNOWN American Headache Society Choosing Wisely Task Force
Dec 24, 2014·Headache·Alessandra CarusoAlyssa LeBel

❮ Previous
Next ❯

Citations

Jul 24, 2020·Expert Review of Neurotherapeutics·Rashmi Rao, Andrew D Hershey
Jan 26, 2020·Scientific Reports·Eva FejesAntal Tibold
May 29, 2021·Continuum : Lifelong Learning in Neurology·Christina Szperka

❮ Previous
Next ❯

Software Mentioned

Clarity
Epic
First DataBank

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.