Practice variation after implementation of a protocol for migraines in children.
The objective of this study was to evaluate the changes that occurred in the treatment of migraine over a 10-year period in a pediatric emergency department (ED) after the implementation of a protocol. The method employed was a comparative retrospective chart review of children diagnosed with migraine in an ED. The two study periods were 1996-1997, and 2006-2007. A protocol suggesting a specific approach was implemented in the ED in 1999. The primary outcome was the medications used in the ED. There were 182 visits for migraine in 2006-2007 compared with 144 visits in 1996-1997. More patients were treated in the ED in 2006-2007 compared with 1996-1997: 50 versus 30%, a difference of 20% (95% confidence interval: 9, 30). The treatments used were also different. In conclusion, a variation in the treatment of migraine was observed over a 10-year period in a pediatric ED after the implementation of a treatment protocol.
Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
Evelyne D
ED
Trottier
Benoit
B
Bailey
Sabine
S
Dauphin-Pierre
Jean-Pierre
JP
Doray
Marilyn
M
Dusseault
Jocelyn
J
Gravel
D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002648:Child; D002985:Clinical Protocols; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal