A study presented last week at the 57th Annual Scientific Meeting of the American Headache Society has found that too many children suffering with migraines are not getting any medication for their pain and too few are receiving care consistent with evidence-based guidelines.

“We discovered that the best care occurs for children diagnosed with migraine who are treated in a primary care setting,” said lead author Robert A. Nicholson, PhD, Director of Behavioral Medicine, Mercy Clinic Headache Center & Mercy Health Research in St. Louis.

In fact, 46% of all children were not prescribed or recommended any medication and 84% were not prescribed or recommended evidence-based acute medication. However, girls’ likelihood of getting evidence-based medication was higher than boys’, and overall the best care occurred in a primary care setting, rather than in an emergency room or urgent care clinic.

“We know which medications work best in children and teens with migraine,” Dr. Nicholson said. “It’s time that healthcare providers understand that evidence-based care is the right way to go.”

“Evidenced-based” medications are those designated as Level A or B in published guidelines, have been considered best evidence in published expert consensus, or have FDA approval. These include triptans, as well as some non-steroidal anti-inflammatory drugs (NSAIDS) and certain analgesic medications.

The children and teens in the study came from four states in metropolitan and non-metropolitan areas to either primary care, specialty care, or Emergency Department/Urgent Care (ED/UC). The study found that providers in metropolitan areas were less likely to prescribe evidence-based medications and those in EDs/UCs were less likely to prescribe pain medication.

American Headache Society
June 2015

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