{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T07:32:16Z","timestamp":1768721536878,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T00:00:00Z","timestamp":1586304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Acute migraine is associated with significant personal, economic and work\u2010related disability. Management guidelines advise the use of simple analgesia, triptans, chlorpromazine and anti\u2010emetics based on severity, with avoidance of opioids. We aimed to determine consistency of prescribing patterns in our ED with national guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort analysis of migraine presentations (ICD\u201010\u2010AM G439) between 2012 and 2016. Exclusion criteria included migraine without headache, other primary headaches and secondary headaches. Demographic and prescribing data were extracted from medical records. Results have been reported as proportions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 4769 headache presentations, the application of exclusion criteria led to a total of 744 patients who received a migraine diagnosis (G439). Most were female (558\/744, 75%), young (mean age 36.4 years) and had a self\u2010reported migraine history (558\/744, 75%). There were 54 different medications prescribed. Paracetamol was more frequently prescribed (385\/744, 52%) than aspirin (134\/744, 18%). Opioid prescription occurred in nearly half of all presentations (345\/744, 46%). Similar opioid prescriptions were also observed in those with a documented history of migraines (253\/558, 45%). A minority of patients received triptans (51\/744, 7%). Overall, a quarter of patients (189\/744, 25%) received no guideline\u2010recommended medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We observed considerable polypharmacy in ED migraine management with inconsistent prescribing patterns. Recommended medications were infrequently used and opioid use was common. Factors influencing prescribing patterns require further investigation in order to improve rates of guideline recommended treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13504","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:09:54Z","timestamp":1586390994000},"page":"763-768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Overuse of opioids for acute migraine in an Australian emergency department"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2292-8155","authenticated-orcid":false,"given":"Lakshini","family":"Gunasekera","sequence":"first","affiliation":[{"name":"Department of Neurology St Vincent's Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed","family":"Akhlaghi","sequence":"additional","affiliation":[{"name":"Emergency Department St Vincent's Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Sun\u2010Edelstein","sequence":"additional","affiliation":[{"name":"Department of Neurology St Vincent's Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Heywood","sequence":"additional","affiliation":[{"name":"Department of Neurology St Vincent's Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Neurology St Vincent's Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2007.01288.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000252808.97649.21"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102415580099"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.suppl_1.S4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.suppl_1.S13"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2003.00543.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12074"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2009.01206.x"},{"key":"e_1_2_8_10_1","first-page":"1","article-title":"Evaluation of the assessment and management of acute migraines in two Australian metropolitan emergency departments","volume":"10","author":"Cheng CT","year":"2016","journal-title":"JEMTAC"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.5847\/wjem.j.1920-8642.2017.03.002"},{"key":"e_1_2_8_12_1","first-page":"21","volume-title":"Emergency Care Acute Pain Management Manual","author":"National Institute of Clinical Studies","year":"2011"},{"key":"e_1_2_8_13_1","volume-title":"Therapeutic Guidelines: Neurology. 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