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• W2078141885 abstract "Published data from 1998 reveal that most patients treated for migraine in an emergency department (ED) received opioids. Over the intervening years, a large body of evidence has emerged demonstrating the efficacy and safety of non-opioid alternatives. Our objective was to compare the current frequency of use of various medications for acute migraine in US EDs with use of the same medications in 1998, and to determine factors associated with opioid use. We analyzed National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2010, the most recently available dataset. NHAMCS is a probabilistic sample from randomly selected ED across the country, designed to be representative of all US ED visits. We included in our dataset all patients with the ICD9 ED discharge diagnosis of migraine. We tabulated frequency of use of specific medications using SPSS v.21’s complex samples module. We explored the association between opioid use and gender, frequency of ED use, geographic region, and type of hospital (Non-profit, Government, or Proprietary). In 2010, there were 1.2 (95%CI: 0.9, 1.4) million migraine visit to US EDs. Opioids were administered in 49% of visits (95%CI: 40, 58%). The most commonly used parenteral agent, hydromorphone, was used in 25% (95%CI: 19, 33%) of visits in 2010 while in 1998, its use was exceedingly uncommon. Conversely, use of meperidine had decreased markedly: 2010- 7% (4, 12%); 1998-37% (29, 45%) Opioid use was less common in men (34% [95%CI: 19, 52%]) than women (53% [95%CI: 44, 63%]) (OR 0.44, 95%CI: 0.197, 0.995) and less common among patients who had not previously used the ED (41% [95%CI: 26, 58%]) than those who previously used an ED 1-3 times annually (54% [95%CI: 40, 68%]), or 4 or more times annually (65% [95%: 43, 82%]) (OR for not at all versus 4 or more times : 0.37, 95%CI: 0.12, 1.1). We did not identify differences in opioid use among geographic regions (Northeast, Midwest, South, West) or among types of hospital." @default.
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• W2078141885 date "2014-04-01" @default.
• W2078141885 modified "2023-09-23" @default.
• W2078141885 title "(137) Lack of evolution of Emergency Department treatment of migraine" @default.
• W2078141885 doi "https://doi.org/10.1016/j.jpain.2014.01.043" @default.
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