For patients with migraine in the emergency department (ED), the use of IV fluids, dopamine receptor antagonists (DRA), nonsteroidal anti-Inflammatory drugs, and corticosteroids increased whereas the use of narcotics and discharge prescriptions for narcotics decreased, according to a recent study. Researchers also found that the return rates for migraines decreased and they speculate that the increased use of non-narcotic medications contributed to this decrease. In this study, they examined a multi-hospital retrospective cohort consisting of consecutive ED patients from January 1, 1999, to September 31, 2014. They examined charts at the beginning and end of the time period and found:
- Of the 2,824,710 total visits, 8046 (0.28%) were for migraine.
- 290 charts (147 in 1999–2000 and 143 in 2014) were reviewed to determine migraine treatments.
- Of the 8046 migraine patients, 624 (8%) returned within 72 hours.
- The return rate decreased from 1999–2000 to 2014 from 12% to 4% (difference = 8%).
Ruzek M, Richman P, Eskin B, Allegra JR. ED treatment of migraine patients has changed. [Published online ahead of print August 20, 2018]. Am J Emerg Med . doi:10.1016/j.ajem.2018.08.051.