Practice Variation in the Treatment of Children with Migraine in the Emergency Department

• Author / Creator

  Richer, Lawrence

• This thesis presents the results of three studies examining the management
  of migraine in children. First we conducted a systematic review of all clinical
  trials conducted in children and adolescents of the acute migraine therapy. A
  meta-analysis of the 26 randomized controlled trials is presented. A single trial with a focus on Emergency Department (ED) management was identified. As such, we then examined current ED practice in two retrospective practice
  variation studies. The first compared four regional hospital EDs where practice patterns were significantly different between mixed population EDs (both adult and pediatric patients) and the tertiary pediatric ED. The second examined practice variation among ten tertiary pediatric EDs in Canada where significant differences were again observed. Factors that influenced the choice of medications included increasing patient age and the physician’s diagnosis of migraine. Important areas of future investigation include: (1) the effectiveness of intravenous fluids alone; and (2) the use of combined medications.

• Subjects / Keywords

  • Placebo response
  • Systematic reviews
  • Emergency department
  • Practice variation
  • Migraine

• Graduation date

  Fall 2009

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R3FM6C

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.