Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017;8(3):170-176.
doi: 10.5847/wjem.j.1920-8642.2017.03.002.

The presenting and prescribing patterns of migraine in an Australian emergency department: A descriptive exploratory study

Emily Shao  1 , James Hughes  2 , Rob Eley  2   3
Affiliations

The presenting and prescribing patterns of migraine in an Australian emergency department: A descriptive exploratory study

Emily Shao et al. World J Emerg Med. 2017.

Abstract

Background: Migraine is a common neurological condition that frequently presents to the emergency department (ED). Many medications are available to treat migraine. This study aims to characterize the demographics of patients who present to a large metropolitan ED with migraine, and to identify the medications used in treating this condition.

Methods: This study is a retrospective database interrogation of clinical records, used to collect quantitative data on patient demographics and medication prescriptions in the ED.

Results: A total of 2 228 patients were identified as being treated for migraine over a 10-year period. The proportion of the ED population presenting with migraine steadily increased in this time. Females (71%) more commonly presented to the ED with migraine than males. The migraine population was significantly younger (M=37.05, SD=13.23) than the whole ED population (M=46.17 SD=20.50) (P<0.001). A variety of medications were used in the treatment of migraine in the ED. Simple analgesics such as paracetamol and ibuprofen, anti-emetics and intravenous (IV) fluids with phenothiazine additives were commonly used. Over 20% of patients were prescribed oral or parenteral opiates (42 of 194 initial medication prescriptions, and 64 of 292 as required medication prescriptions). Triptans were very rarely used.

Conclusion: Migraine is an increasingly common presentation to the ED. People presenting to the ED with migraine are more likely to be younger and female than the general ED population. Peak presentations for migraines occurred in January and February. The medications that are prescribed in the ED for migraine is varied and are not always in line with current evidence for the treatment of migraine. The excessive reliance on opiates and lack of the use of triptans denotes a significant variation from published guidelines.

Keywords: Analgesia; Emergency department; Headache; Migraine; Pain.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: There is no conflict of interest related to this study.

Figures

Figure 1
Figure 1
Included patients in migraine group.
Figure 2
Figure 2
Percentage of the total ED presentations presenting with migraine over time.
See this image and copyright information in PMC

References

    1. Lipton R, Stewart W, Diamond S, Diamond M. Prevalence and burden of migraine in the United States:Data From the American Migraine Study II. Headache. 2001;41(7):646–57. - PubMed
    1. Smetana GW. The diagnostic value of historical features in primary headache syndromes:A comprehensive review. Arch Intern Med. 2000;160(18):2729–37. - PubMed
    1. Wöber C, Wöber-Bingöl Ç. Triggers of migraine and tension-type headache. Handb Clin Neurol. 2010;97(C):161–72. - PubMed
    1. Stewart WF, Lipton RB, Simon D. Work-related disability:Results from the American Migraine Study. Cephalalgia. 1996;16(4):231–8. - PubMed
    1. Year Book Australia 2012. Statistics ABo. Canberra, Australia 2012:

LinkOut - more resources