Differences in Pediatric Headache Prescription Patterns by Diagnosis

Rabner, Jonathan; Ludwick, Allison; Lebel, Alyssa

doi:10.1007/s40272-017-0279-4

Cited by 8 publications

(8 citation statements)

References 37 publications

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“…“Other migraine diagnosis” included menstrual migraine (G43.821, G43.829, G43.831, G43.839), hemiplegic migraine (G43.401, G43.409, G43.411, G43.419), and migraine with persistent aura without infarction (G43.501, G43.509, G43.511, G43.519). These ICD‐10 codes for migraine were adapted from prior studies 12,13 . Each patient could have more than one migraine diagnosis if multiple ICD‐10 codes were assigned.…”

Section: Methodsmentioning

confidence: 99%

“…These ICD-10 codes for migraine were adapted from prior studies. 12,13 Each patient could have more than one migraine diagnosis if multiple ICD-10 codes were assigned. If a patient had another ICD-10 headache diagnosis in addition to a migraine diagnosis, the patient also received a designation of "other headache diagnosis."…”

Section: Headache Diagnoses and Comorbiditiesmentioning

confidence: 99%

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Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study

Shapiro,

Loder,

Shapiro

2023

Headache

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ObjectiveWe aimed to compare the prescribing patterns of preventive medications between pediatric and adult neurologists for young adults with migraine.BackgroundAlthough preventive medications are effective for adults with migraine, studies in children have failed to demonstrate similar efficacy. As a result, lifestyle modifications and non‐pharmacological interventions are often emphasized in children. It is not known whether young adults are prescribed preventive medications at different rates according to whether they are cared for by an adult or pediatric neurologist.MethodsWe performed a multicenter retrospective cohort analysis of patients with migraine aged 18–25 years who were seen by a pediatric or adult neurologist at Mass General Brigham Hospital between 2017 and 2021. The primary outcome was whether the patient received a prescription for any preventive medication during the study period.ResultsAmong the 767 included patients, 290 (37.8%) were seen by a pediatric neurologist. Preventive medications were prescribed for 131/290 (45.2%; 95% confidence interval [CI]: 39.5%, 51.0%) patients seen by a pediatric neurologist and 206/477 (43.2%; 95% CI: 39.0%, 47.7%) patients seen by an adult neurologist (p = 0.591). In the mixed effects logistic regression model, clinician specialty was not associated with preventive medication use (adjusted odds ratio [AOR] 1.20, 95% CI: 0.62, 2.31). Female sex (AOR 1.69, 95% CI: 1.07, 2.66) and number of visits during the study period (AOR 1.64, 95% CI: 1.49, 1.80) were associated with receiving preventive medication.ConclusionApproximately two fifths of young adults with migraine were prescribed preventive medications, and this proportion did not differ according to clinician specialty. Although these findings suggest that pediatric and adult neurologists provide comparable care, both specialties may be underusing preventive medications in this patient population.

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Section: Methodsmentioning

confidence: 99%

Section: Headache Diagnoses and Comorbiditiesmentioning

confidence: 99%

Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study

Shapiro,

Loder,

Shapiro

2023

Headache

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“…Within the CDH population at tertiary centers, the prevalence of NDPH in children and adolescents ranges from 0.9 to 35%, compared to 1.7 to 10.8% in adults [19]. It maintains a female predominance throughout life, with a 2.5:1 female/male ratio in adults and a 1.8:1 female/male ratio in children and adolescents, and has an earlier age at onset in females (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) than in males (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) [2].…”

Section: Epidemiologymentioning

confidence: 99%

New Daily Persistent Headache in the Pediatric and Adolescent Population: An Updated Review

Kalika,

Monteith

2024

Life

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Purpose of review: New daily persistent headache (NDPH) is a primary headache disorder characterized by the sudden onset of continuous pain and its intractability to treatment. It is more prevalent in the pediatric population than the adult population, but remains understudied and underdiagnosed. The purpose of the current article is to provide a current overview of new daily persistent headache in the pediatric and adolescent population, including history, pathophysiology, clinical findings, current and emerging treatment options, and the results of recent studies and meta-analyses. Recent findings: Despite recent studies and meta-analyses showing significant phenotypic overlap between chronic migraine and NDPH in the pediatric population, multiple recent studies have come to conflicting conclusions about the overlap of medication overuse in headache and pediatric NDPH. Recent studies reveal alterations in neuroimaging, particularly in functional connectivity, in patients with NDPH. Patients frequently remain treatment-refractory even to medications that have historically proven helpful in this population; however, new treatment options, including calcitonin gene-related peptide (CGRP) monoclonal antibodies, may be more effective. Summary: NPDH remains a perplexing and difficult-to-manage condition for both children and adults. Despite a higher prevalence in the pediatric population, there are relatively few studies to guide the evaluation and treatment of NDPH in pediatric and adolescent patients. Early treatment, both pharmacological and non-pharmacological, should be employed to reduce disability. Overall, further studies are needed to better understand pathogenesis and to identify more effective therapeutic strategies, both pharmacological and non-pharmacological.

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“…Bei Kindern und Jugendlichen mit NDPH wurde eine Reduzierung der Kopfschmerzen um > 50 % bei 30,6 % der Betroffenen durch Amitriptylin beobachtet [24]. Eine Feldstudie aus den USA über Verschreibungen bei chronischen Kopfschmerzen bei Kindern und Jugendlichen ergab, dass beim NDPH Amitriptylin und danach Topiramat am häufigsten verschrieben wurden [56]. Für Venlafaxin liegt ein positiver Fallbericht bei einem Erwachsenen vor [57].…”

Section: Antidepressivaunclassified

Neu aufgetretener täglicher Kopfschmerz

Evers¹

2022

Nervenheilkunde

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ZUSAMMENFASSUNGDer neu aufgetretene tägliche Kopfschmerz (englisch: new daily persistent headache, NDPH) ist 2004 als eigenständiger idiopathischer Kopfschmerz in die International Classification of Headache Disorders aufgenommen worden. Er ist wenig bekannt, obwohl die Prävalenz in etwa der des Clusterkopfschmerzes entspricht. Der Kopfschmerz ist definiert durch seinen plötzlichen Beginn innerhalb eines Tages und das seitdem ununterbrochene Auftreten ohne jegliche Pause. Der Kopfschmerz selbst ist unspezifisch und meistens von mittlerer Intensität. Die Pathophysiologie ist gänzlich unbekannt, obwohl eine postinfektiöse Genese immer wieder postuliert worden ist. Ein weiteres Merkmal ist das sehr schlechte Ansprechen auf sämtliche Therapieverfahren. Die Therapie ist dementsprechend rein empirisch; intravenöse Infusionen mit Lidocain oder Ketamin scheinen die beste, aber nur eine kurz anhaltende Wirksamkeit zu zeigen. Botulinumtoxin ist ebenfalls in einigen Fällen als wirksam beschrieben worden. Orale Therapieversuche scheitern sehr häufig. Wichtig für die Betroffenen ist es vor allem, eine korrekte Diagnose zu erhalten und zu lernen, mit dem Kopfschmerz umzugehen.

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Differences in Pediatric Headache Prescription Patterns by Diagnosis

Cited by 8 publications

References 37 publications

Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study

Association between clinician specialty and prescription of preventive medication for young adults with migraine: A retrospective cohort study

New Daily Persistent Headache in the Pediatric and Adolescent Population: An Updated Review

Neu aufgetretener täglicher Kopfschmerz

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