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Three observational studies will be presented this week at the 61st Annual Scientific Meeting of the American Headache Society (AHS) in Philadelphia. The studies provide insights into how opioids are used to treat migraine in various acute care settings.
Migraine treatment in emergency
An analysis of an unidentified longitudinal electronic health records database from 2010 to 2016 examined 14,494 unique visits to an emergency department (ED) of adolescents and young adults with migraine diagnosed. In 23% of these visits, health care providers ordered an opioid within 12 hours of admission to the ED, and in more than half of these cases (58%) an opioid was ordered first-line treatment. Titled "Rates and Predictors of the Use of Opioids in Emergency Services to Treat Migraine in Adolescents and Young Adults", the study also revealed that the likelihood of Opioid administration was considerably higher if a patient was older and seen by a surgeon than by an emergency physician. doctor. However, opioid administration rates to treat migraine in the emergency department decreased significantly during the observation period.
Impact of the formal diagnosis of migraine on the treatment plan
An analysis of the CaMEO (Chronic Migraine Epidemiology and Outcome) study included 2,388 respondents who reported taking or having prescription pain medications for migraine. Surprisingly, 36.3% of this sample used opioids. Compared to non-opioid users, opioid patients reported high monthly headache days, the use of emergency care for the treatment of headaches, allodynia, depression and depression. 39, anxiety and comorbidity CV. However, the study found a downward trend in opioid use when a doctor makes an official diagnosis of migraine. Making a specific migraine diagnosis increases the use of migraine-specific treatments rather than general analgesics such as opioids.
Use of Opioids and Mental Health Factors in Migraine Care
A separate analysis examining data from an observational study of 21,143 people living with migraine found that patients who reported having already used opioids or had previously used opioids were more likely to have depression. or anxiety that migraine patients have never used opioids. This analysis was based on data collected as part of the observational survey of the study Migraine Epidemiology, Treatment and Care (OVERCOME). From this cross-sectional study, it is unclear whether opioids contribute to the development of depression and anxiety or whether depression and anxiety are associated with prescribing drugs. 39; opioids.
The research reinforces the link between the use of opioids in the treatment of migraine and negative impacts such as depression, anxiety and comorbidity CV. Patients have been shown to benefit greatly from alternative and targeted treatment options when they are able to work closely with a migraine specialist to develop a personalized treatment plan.
"Opioids are generally not recommended for the treatment of migraine due to limited evidence of efficacy, risk of addiction and the fact that opioid treatment is a risk factor for exacerbation of seizures. head. The very medication that relieves pain in the short term can lead to the onset of a chronic migraine, "said Richard Lipton, MD, FAHS and past president of the American Headache Society and principal investigator of two of the three studies presented. "Given the chronic nature of migraine, it is essential to find solutions that go beyond acute management, but we also need to be compassionate when patients experience the pain of a migraine attack. "
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