A randomized controlled trial of a comprehensive migraine intervention prior to discharge from an emergency department.

摘要: ACADEMIC EMERGENCY MEDICINE 2012; 19:1151–1157 © 2012 by the Society for Academic Emergency Medicine Abstract Objectives:  Patients who use an emergency department (ED) acute migraine headaches have higher disability scores, lower socioeconomic status, and are unlikely to used a migraine-specific medication prior presentation ED. The objective was determine if comprehensive intervention, delivered just ED discharge, could improve impact scores 1 month after visit. Methods:  This randomized controlled trial of intervention versus typical care among patients presented management migraine. At time care, research team reinforced their diagnosis, shared education from National Library Medicine, provided them with six tablets sumatriptan 100 mg 14 naproxen 500 mg, they wished, expedited free appointment institution’s headache clinic. received attending physicians (EPs) felt appropriate. primary outcome between-group comparison Headache Impact Test (HIT-6) score, validated assessment instrument, discharge. Secondary outcomes included satisfaction within that 1-month period. Results:  Over 19-month period, 50 were enrolled. One-month follow-up successfully obtained in 92% patients. Baseline characteristics comparable. HIT-6 two groups nearly identical (59 vs. 56, 95% confidence interval [CI] difference 3 = −5 11), as dissatisfaction overall (17% 18%, CI 1% = −22% 24%). more likely be using triptans or therapy (43% 0%, 43% = 20 63%) later. Conclusions:  A when compared did not (a measure effect on one’s daily life) Future work is needed define practical useful ED, where many underserved patients, necessity, present care. Resumen Objetivos:  Los pacientes que acuden al servicio de urgencias (SU) por cefelea debida una migrana aguda tienen mayores puntuaciones discapacidad la migrana, menor nivel socioeconomico y probabilidad haber tomado un farmaco especifico para previamente atencion en el SU. El objetivo fue determinar si intervencion global realizada alta del SU, podia mejorar las impacto mes tras visita SU. Metodo:  Ensayo clinico controlado con asignacion aleatoria estandar los acudieron SU manejo episodio agudo migrana. En momento alta, fueron asignados global, protocolo estudio reforzo su diagnostico, compartio presentacion formativa sobre se les suministro seis comprimidos 100mg naproxeno 500mg y, lo deseaban, concerto cita gratuita unidad cefaleas institucion. recibieron considerada apropiada urgenciologos. resultado principal comparacion entre grupos puntuacion (HIT-6), instrumento validado valoracion cefalea, resultados secundarios incluyeron satisfaccion cefalea frecuencia uso medicacion especifica durante periodo mes. Resultados:  19 meses, incluyo seguimiento obtuvo pacientes. Las caracteristicas basales comparables. dos casi identica IC diferencia = −5 asi como insatisfaccion diferencia = −22% tuvieron mas tomar triptanes o terapia 0%; diferencia = 20 siguiente. Conclusiones:  Una cuando comparo estandar, no mejoro (una medida validada efecto dia vida diaria) Futuros trabajos son necesarios definir sea practica util donde muchos subatendidos necesidad recibir atencion.