Children & Teenagers Receive Inadequate Migraine Care
Five out of six children and teenagers diagnosed with migraine aren’t receiving optimal care and nearly one in six are prescribed opioids, according to two papers presented at the American Headache Society meeting in June. Both papers came from the same study, which reviewed the records of nearly 40,000 American children ages six to 17.
Researchers found that nearly half (46%) the kids were not prescribed or recommended any medication. 84% were not provided migraine abortive treatments with a track record for being effective (evidence-based). These medications include triptans, some NSAIDs, and other analgesics. Girls were more likely than boys to get evidence-based medication.
Although opioids are not evidence-based, and can actually worsen migraine and headache disorders, 16% of children received prescriptions for them. Girls and Caucasian children were most likely to be prescribed opioids. The older the child, the more likely they were to be prescribed an opioid. Among teenagers 15-17, 25% of those who were offered medication were prescribed an opioid.
Children and teenagers received better migraine care with primary care physicians than in they did in an emergency room or urgent care clinic. Providers in major metropolitan areas were less likely to prescribe evidence-based medication than those in non-metropolitan areas.
“There are significant dangers in prescribing opioids for migraine in children and teens," said lead author Robert A. Nicholson, PhD, "and enormous need to increase provider awareness of the benefits of optimal migraine care." Dr. Nicholson also said, “We know which medications work best in children and teens with migraine. It’s time that healthcare providers understand that evidence-based care is the right way to go.”
References
American Headache Society Press release. Despite Risks, Use of Opioids to Treat Migraine in Children is Common Across the U.S. June 17, 2015.
American Headache Society Press release. Teens and Young Children Not Getting Optimal Care for Migraine Pain. June 17, 2015.
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