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Headache Disorder Management Trends

Data from the National Hospital Ambulatory Medical Care Survey

The Journal of Clinical Medicine has published an article: Trends in the Management of Headache Disorders in US Emergency Departments: Analysis of 2007–2018 National Hospital Ambulatory Medical Care Survey Data. Researchers identified headache disorders—including migraine, tension-type headache, trigeminal autonomic cephalgia, or not otherwise specified headache—and trends involving neuroimaging, outpatient referrals, and medications including opioids, butalbital, ergot alkaloids/triptans, NSAIDs, antiemetics, diphenhydramine, and corticosteroids.

Findings include:

  • 32.9% of the 33 million headache-related ED visits from 2007 to 2018 were due to migraines
  • People with migraine visiting the ED were more likely to be:
    • Aged <50 years (78.1% vs 66.5%)
    • Females (82.0% vs 68.0%)
    • Whites (82.2% vs 64.7%)
    • With depression (17.5% vs 12.1%)
    • Severe pain (65.0% vs 47.3%)
    • In metropolitan areas (88.5% vs 81.2%)
  • Compared to not otherwise specified headache-related visits, migraine-related visits had a greater use of:
    • Ergot alkaloids/triptans (9.7% vs 1.9%)
    • Antiemetics (80.3% vs 48.3%)
    • Diphenhydramine (47.5% vs 30.0%)
    • IV fluids (48.1% vs 37.9%)

The study concluded, “Future studies are warranted to identify strategies to promote evidence-based treatments for headaches (e.g., sumatriptan and dexamethasone) and appropriate outpatient referrals for follow-up…”


Read the journal article.

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