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Review

An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review

1
Department of Neurology, AIMSS, Sunshine Hospital, Western Health, Melbourne, St Albans, VIC 3021, Australia
2
School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3083, Australia
3
Department of Medicine, Faculty of Medicine, Rajarata University, Saliyapura, Anuradhapuraya 50000, Sri Lanka
*
Author to whom correspondence should be addressed.
Academic Editor: Anna P. Andreou
J. Clin. Med. 2021, 10(6), 1191; https://doi.org/10.3390/jcm10061191
Received: 29 December 2020 / Revised: 4 March 2021 / Accepted: 5 March 2021 / Published: 12 March 2021
(This article belongs to the Special Issue New Trends and Advances in Treatment Headache Disorders)
Migraine is one of the leading causes of disability worldwide and patients with acute migraine frequently present to emergency departments (ED). The current literature suggests that ED treatment of migraine headache varies across institutions. Considering this, we conducted a scoping review to summarize trends in medication prescribing patterns for acute migraine treatment in the ED setting. Trends were evaluated for factors influencing treatment choices, with particular attention placed on opioids and migraine specific therapy. This scoping review was based on the Arksey and O’Malley methodological framework and included studies published between 1 January 2000 and 31 May 2020. 14 publications met the inclusion criteria. The most common classes of medication prescribed were anti-emetics or Non-steroidal anti-inflammatory drugs (NSAID), but rates varied between studies. There was a concerning trend towards an underutilization of triptans and overutilization of opiates. The use of specific clinical treatment goals (e.g., two-hour pain free freedom response) was also not evident. Additionally, 88% (n = 8) of the nine studies commenting on adherence to hospital or evidence-based guidelines stated that practices were non-adherent. Overall, the reviewed literature reveals treatment practices for acute migraine in the ED are heterogeneous and deviate from established international recommendations. View Full-Text
Keywords: migraine; acute care; emergency department; analgesic; triptan; opioid; NSAID migraine; acute care; emergency department; analgesic; triptan; opioid; NSAID
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MDPI and ACS Style

Lim, J.H.; Karimi, L.; Wijeratne, T. An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review. J. Clin. Med. 2021, 10, 1191. https://doi.org/10.3390/jcm10061191

AMA Style

Lim JH, Karimi L, Wijeratne T. An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review. Journal of Clinical Medicine. 2021; 10(6):1191. https://doi.org/10.3390/jcm10061191

Chicago/Turabian Style

Lim, Jun H., Leila Karimi, and Tissa Wijeratne. 2021. "An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review" Journal of Clinical Medicine 10, no. 6: 1191. https://doi.org/10.3390/jcm10061191

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