Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists
Objective This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in chi...
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| Veröffentlicht in: | Headache 2019-10, Vol.59 (9), p.1537-1546 |
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| creator | Gutta, Radhika Valentini, Kelly J. Kaur, Gunjanpreet Farooqi, Ahmad A. Sivaswamy, Lalitha |
| description | Objective
This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in children treated by the two groups of physicians.
Methods
A retrospective cohort study was conducted by utilizing the electronic medical records of children 3‐18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018.
Results
Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high‐frequency episodic migraine and were followed‐up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5‐HT agonists (“triptans”) for migraine management in 56.7% (76/135) of cases compared to non‐headache specialists who prescribed them in 28.7% (96/334) of cases (P |
| doi_str_mv | 10.1111/head.13660 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2299146509</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2299146509</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3930-16b3975bb717283293f9ed68168a9242c377bb95faee30992ce7b7c1e0022f443</originalsourceid><addsrcrecordid>eNp9kLtOwzAUQC0EoqWw8AHIEgtCSvEjseOxKoUitTBAZ8tJbhpXaVLiBtSNT-Ab-RJSUhgQwssdfHTu1UHolJI-bd5VBibpUy4E2UNdGjDh-YKSfdQlhEovlH7YQUfOLQghvlDiEHU4DQLJWdhFs6kpzByWUKxxmeJhZvMkK8sET-28MrYAHG3wuFlg4gzw4wpia3Lr1vjF4fuy-Hh7_-PTHaOD1OQOTnazh2Y3o6fh2Js83N4NBxMv5ooTj4qIKxlEkaSShZwpnipIREhFaBTzWcyljCIVpAaAE6VYDDKSMQVCGEt9n_fQRetdVeVzDW6tl9bFkOemgLJ2mjGlqC8Cohr0_Be6KOuqaK7TjBMuiaIiaKjLloqr0rkKUr2q7NJUG02J3sbW29j6K3YDn-2UdbSE5Af9rtsAtAVebQ6bf1R6PBpct9JPeQCIOQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2303709165</pqid></control><display><type>article</type><title>Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists</title><source>Wiley Online Library All Journals</source><creator>Gutta, Radhika ; Valentini, Kelly J. ; Kaur, Gunjanpreet ; Farooqi, Ahmad A. ; Sivaswamy, Lalitha</creator><creatorcontrib>Gutta, Radhika ; Valentini, Kelly J. ; Kaur, Gunjanpreet ; Farooqi, Ahmad A. ; Sivaswamy, Lalitha</creatorcontrib><description>Objective
This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in children treated by the two groups of physicians.
Methods
A retrospective cohort study was conducted by utilizing the electronic medical records of children 3‐18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018.
Results
Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high‐frequency episodic migraine and were followed‐up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5‐HT agonists (“triptans”) for migraine management in 56.7% (76/135) of cases compared to non‐headache specialists who prescribed them in 28.7% (96/334) of cases (P < .001). Of the children with chronic migraine, the headache specialist evaluated 135 patients while the non‐headache specialists treated 334 children. Non‐headache specialists prescribed prophylaxis in the form of natural supplements more frequently (63.8% of cases) compared to the headache specialist (38.5% of children) (P < .001). Moreover, prophylaxis with prescription drugs was utilized more often by headache specialist (66.7%) than non‐headache specialists (37.4%) (P < .001).
Conclusions
Imaging appears to be commonly recommended by both headache specialists and non‐headache specialists in children with migraine. The headache specialist was more likely to use triptans as rescue medications for pediatric migraine. Outcomes in the short‐term were not statistically different whether children were being managed by the headache specialist or the non‐headache specialists.</description><identifier>ISSN: 0017-8748</identifier><identifier>EISSN: 1526-4610</identifier><identifier>DOI: 10.1111/head.13660</identifier><identifier>PMID: 31557328</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Childhood ; Children ; Electronic health records ; Electronic medical records ; Headache ; headache specialist ; Headaches ; imaging ; Management ; Medical imaging ; Medical personnel ; Migraine ; Neuroimaging ; Neurology ; Patients ; pediatric ; Physicians ; Prophylaxis</subject><ispartof>Headache, 2019-10, Vol.59 (9), p.1537-1546</ispartof><rights>2019 American Headache Society</rights><rights>2019 American Headache Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3930-16b3975bb717283293f9ed68168a9242c377bb95faee30992ce7b7c1e0022f443</citedby><cites>FETCH-LOGICAL-c3930-16b3975bb717283293f9ed68168a9242c377bb95faee30992ce7b7c1e0022f443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhead.13660$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhead.13660$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31557328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gutta, Radhika</creatorcontrib><creatorcontrib>Valentini, Kelly J.</creatorcontrib><creatorcontrib>Kaur, Gunjanpreet</creatorcontrib><creatorcontrib>Farooqi, Ahmad A.</creatorcontrib><creatorcontrib>Sivaswamy, Lalitha</creatorcontrib><title>Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists</title><title>Headache</title><addtitle>Headache</addtitle><description>Objective
This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in children treated by the two groups of physicians.
Methods
A retrospective cohort study was conducted by utilizing the electronic medical records of children 3‐18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018.
Results
Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high‐frequency episodic migraine and were followed‐up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5‐HT agonists (“triptans”) for migraine management in 56.7% (76/135) of cases compared to non‐headache specialists who prescribed them in 28.7% (96/334) of cases (P < .001). Of the children with chronic migraine, the headache specialist evaluated 135 patients while the non‐headache specialists treated 334 children. Non‐headache specialists prescribed prophylaxis in the form of natural supplements more frequently (63.8% of cases) compared to the headache specialist (38.5% of children) (P < .001). Moreover, prophylaxis with prescription drugs was utilized more often by headache specialist (66.7%) than non‐headache specialists (37.4%) (P < .001).
Conclusions
Imaging appears to be commonly recommended by both headache specialists and non‐headache specialists in children with migraine. The headache specialist was more likely to use triptans as rescue medications for pediatric migraine. Outcomes in the short‐term were not statistically different whether children were being managed by the headache specialist or the non‐headache specialists.</description><subject>Childhood</subject><subject>Children</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Headache</subject><subject>headache specialist</subject><subject>Headaches</subject><subject>imaging</subject><subject>Management</subject><subject>Medical imaging</subject><subject>Medical personnel</subject><subject>Migraine</subject><subject>Neuroimaging</subject><subject>Neurology</subject><subject>Patients</subject><subject>pediatric</subject><subject>Physicians</subject><subject>Prophylaxis</subject><issn>0017-8748</issn><issn>1526-4610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kLtOwzAUQC0EoqWw8AHIEgtCSvEjseOxKoUitTBAZ8tJbhpXaVLiBtSNT-Ab-RJSUhgQwssdfHTu1UHolJI-bd5VBibpUy4E2UNdGjDh-YKSfdQlhEovlH7YQUfOLQghvlDiEHU4DQLJWdhFs6kpzByWUKxxmeJhZvMkK8sET-28MrYAHG3wuFlg4gzw4wpia3Lr1vjF4fuy-Hh7_-PTHaOD1OQOTnazh2Y3o6fh2Js83N4NBxMv5ooTj4qIKxlEkaSShZwpnipIREhFaBTzWcyljCIVpAaAE6VYDDKSMQVCGEt9n_fQRetdVeVzDW6tl9bFkOemgLJ2mjGlqC8Cohr0_Be6KOuqaK7TjBMuiaIiaKjLloqr0rkKUr2q7NJUG02J3sbW29j6K3YDn-2UdbSE5Af9rtsAtAVebQ6bf1R6PBpct9JPeQCIOQ</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Gutta, Radhika</creator><creator>Valentini, Kelly J.</creator><creator>Kaur, Gunjanpreet</creator><creator>Farooqi, Ahmad A.</creator><creator>Sivaswamy, Lalitha</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201910</creationdate><title>Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists</title><author>Gutta, Radhika ; Valentini, Kelly J. ; Kaur, Gunjanpreet ; Farooqi, Ahmad A. ; Sivaswamy, Lalitha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3930-16b3975bb717283293f9ed68168a9242c377bb95faee30992ce7b7c1e0022f443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Childhood</topic><topic>Children</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Headache</topic><topic>headache specialist</topic><topic>Headaches</topic><topic>imaging</topic><topic>Management</topic><topic>Medical imaging</topic><topic>Medical personnel</topic><topic>Migraine</topic><topic>Neuroimaging</topic><topic>Neurology</topic><topic>Patients</topic><topic>pediatric</topic><topic>Physicians</topic><topic>Prophylaxis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gutta, Radhika</creatorcontrib><creatorcontrib>Valentini, Kelly J.</creatorcontrib><creatorcontrib>Kaur, Gunjanpreet</creatorcontrib><creatorcontrib>Farooqi, Ahmad A.</creatorcontrib><creatorcontrib>Sivaswamy, Lalitha</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Headache</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gutta, Radhika</au><au>Valentini, Kelly J.</au><au>Kaur, Gunjanpreet</au><au>Farooqi, Ahmad A.</au><au>Sivaswamy, Lalitha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists</atitle><jtitle>Headache</jtitle><addtitle>Headache</addtitle><date>2019-10</date><risdate>2019</risdate><volume>59</volume><issue>9</issue><spage>1537</spage><epage>1546</epage><pages>1537-1546</pages><issn>0017-8748</issn><eissn>1526-4610</eissn><abstract>Objective
This study aims to compare the management practices of a headache specialist with non‐headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short‐term outcomes are compared in children treated by the two groups of physicians.
Methods
A retrospective cohort study was conducted by utilizing the electronic medical records of children 3‐18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018.
Results
Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high‐frequency episodic migraine and were followed‐up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5‐HT agonists (“triptans”) for migraine management in 56.7% (76/135) of cases compared to non‐headache specialists who prescribed them in 28.7% (96/334) of cases (P < .001). Of the children with chronic migraine, the headache specialist evaluated 135 patients while the non‐headache specialists treated 334 children. Non‐headache specialists prescribed prophylaxis in the form of natural supplements more frequently (63.8% of cases) compared to the headache specialist (38.5% of children) (P < .001). Moreover, prophylaxis with prescription drugs was utilized more often by headache specialist (66.7%) than non‐headache specialists (37.4%) (P < .001).
Conclusions
Imaging appears to be commonly recommended by both headache specialists and non‐headache specialists in children with migraine. The headache specialist was more likely to use triptans as rescue medications for pediatric migraine. Outcomes in the short‐term were not statistically different whether children were being managed by the headache specialist or the non‐headache specialists.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31557328</pmid><doi>10.1111/head.13660</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library All Journals |
| subjects | Childhood Children Electronic health records Electronic medical records Headache headache specialist Headaches imaging Management Medical imaging Medical personnel Migraine Neuroimaging Neurology Patients pediatric Physicians Prophylaxis |
| title | Management of Childhood Migraine by Headache Specialist vs Non‐Headache Specialists |
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