Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지
DOI QR코드

DOI QR Code

Medication Prescribing Status in Pediatric Patients with Migraine

소아청소년에서 편두통 치료 약물 처방 현황

  • Rhew, Kiyon (College of Pharmacy, Dongduk Women's University)
  • 유기연 (동덕여자대학교 약학대학)
  • Received : 2022.01.01
  • Accepted : 2022.08.12
  • Published : 2022.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Migraine is one of the leading causes of poor quality of life and disability, and migraine incidences in pediatrics are increasing. Proper medication is important for the preventive and acute treatment of migraine. This study aimed to identify the current status of prescribed medication in pediatric patients with migraine. Methods: We used data from a sample of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2018) and analyzed the status of prescription drugs and frequency of visits to medical institutions with migraine diagnoses in pediatric patients. Results: A total of 12,228 pediatric patients diagnosed with migraine during 2018 were analyzed. Among these patients, 7,170 (58.64%) were girls and 9,510 (77.77%) were adolescents. Additionally, 9,157 patients (74.89%) received acute treatment, and 592 patients (4.84%) received combination therapy with analgesics and triptans. Acetaminophen for acute treatment and flunarizine for preventive treatment were the most commonly prescribed. In most children and adolescents, acute treatment drugs were prescribed for less than 14 days. Conclusion: Analgesics, such as acetaminophen or non-steroidal anti-inflammatory drugs, were prescribed frequently for acute treatment in pediatric patients with migraine. The drug prescription duration was within the recommended range, indicating a low risk of overdose. For preventive treatment, clinically studied medication for pediatric patients with migraine was used.

Keywords

Acknowledgement

이 논문은 2021년도 동덕여자대학교 연구비 지원에 의하여 수행된 것으로 이에 감사드립니다.

References

  1. Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: Updated statistics from government health surveillance studies. Headache 2015;55(1):21-34. https://doi.org/10.1111/head.12482
  2. Smitherman TA, Burch R, Sheikh H, Loder E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: A review of statistics from national surveillance studies. Headache 2013;53(3):427-36. https://doi.org/10.1111/head.12074
  3. Ashina M. Migraine. N Engl J Med 2020;383(19):1866-76. https://doi.org/10.1056/NEJMra1915327
  4. Mortimer MJ, Kay J, Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using Ad Hoc, Vahlquist and IHS criteria. Dev Med Child Neurol 1992;34(12):1095-101. https://doi.org/10.1111/j.1469-8749.1992.tb11423.x
  5. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2018;17(11):954-76. https://doi.org/10.1016/S1474-4422(18)30322-3
  6. Rho YI, Chung HJ, Lee KH, et al. Prevalence and clinical characteristics of primary headaches among school children in South Korea: a nationwide survey. Headache 2012;52(4):592-9. https://doi.org/10.1111/j.1526-4610.2011.02001.x
  7. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventative therapy. Neurology 2007;68(5):343-9. https://doi.org/10.1212/01.wnl.0000252808.97649.21
  8. Deubner DC. An epidemiologic study of migraine and headache in 10-20 year olds. Headache 1977;17(4):173-80. https://doi.org/10.1111/j.1526-4610.1977.hed1704173.x
  9. Lee LH, Olness KN. Clinical and demographic characteristics of migraine in urban children. Headache 1997;37(5):269-76. https://doi.org/10.1046/j.1526-4610.1997.3705269.x
  10. KH Lee. Recent updates on treatment for pediatric migraine. J Korean Med Assoc 2017:60(2):118-25. https://doi.org/10.5124/jkma.2017.60.2.118
  11. Eun SH, Eun BL. Headaches in children and adolescents: diagnosis and treatment. Korean J Pediatr 2006:49(4);354-63. https://doi.org/10.3345/kjp.2006.49.4.354
  12. Patniyot I, Qubty W. Short-term treatment of migraine in children and adolescents. JAMA Pediatr 2020;174(8):789-90. https://doi.org/10.1001/jamapediatrics.2020.1422
  13. Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2019;93(11):487-99. https://doi.org/10.1212/WNL.0000000000008095
  14. Thorlund K, Sun-Edelstein C, Druyts E, et al. Risk of medication overuse headache across classes of treatments for acute migraine. J Headache Pain. 2016;17(1):107. https://doi.org/10.1186/s10194-016-0696-8
  15. Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB. Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache 2008;48(8):1157-68. https://doi.org/10.1111/j.1526-4610.2008.01217.x
  16. El-Chammas K, Keyes J, Thompson N, Vijayakumar J, Becher D, Jackson JL. Pharmacologic treatment of pediatric headaches: a meta-analysis. JAMA Pediatr 2013;167(3):250-8. https://doi.org/10.1001/jamapediatrics.2013.508
  17. O'Brien HL, Kabbouche MA, Hershey AD. Treating pediatric migraine: an expert opinion. Expert Opin Pharmacother 2012;13(7):959-66. https://doi.org/10.1517/14656566.2012.677434
  18. Shamliyan TA, Kane RL, Ramakrishnan R, Taylor FR. Episodic migraines in children: limited evidence on preventive pharmacological treatments. J Child Neurol 2013;28(10):1320-41. https://doi.org/10.1177/0883073813488659
  19. Hershey AD, Powers SW, Bentti AL, Degrauw TJ. Effectiveness of amitriptyline in the prophylactic management of childhood headaches. Headache 2000;40(7):539-49. https://doi.org/10.1046/j.1526-4610.2000.00085.x
  20. Kim J, Lee S, Rhew K. Association between Gastrointestinal Diseases and Migraine. Int J Environ Res Public Health 2022;19(7):4018. https://doi.org/10.3390/ijerph19074018
  21. Ho TW, Pearlman E, Lewis D, et al. Efficacy and tolerability of rizatriptan in pediatric migraineurs: results from a randomized, double-blind, placebo-controlled trial using a novel adaptive enrichment design. Cephalalgia 2012;32(10):750-65. https://doi.org/10.1177/0333102412451358
  22. Lewis DW, Winner P, Hershey AD, Wasiewski WW; Adolescent Migraine Steering Committee. Efficacy of zolmitriptan nasal spray in adolescent migraine. Pediatrics 2007;120(2):390-6. https://doi.org/10.1542/peds.2007-0085
  23. Lewis DW, Winner P. The pharmacological treatment options for pediatric migraine: An evidence-based appraisal. NeuroRx 2006;3(2):181-91. https://doi.org/10.1016/j.nurx.2006.01.002
  24. Genizi J, Lahoud D, Cohen R. Migraine abortive treatment in children and adolescents in Israel. Sci Rep 2022;12(1):7418. https://doi.org/10.1038/s41598-022-11467-3
  25. Damen L, Bruijn JK, Verhagen AP, Berger MY, Passchier J, Koes BW. Symptomatic treatment of migraine in children: A systematic review of medication trials. Pediatrics 2005;116(2):e295-302. https://doi.org/10.1542/peds.2004-2742
  26. Richer L, Billinghurst L, Linsdell MA, et al. Drugs for the acute treatment of migraine in children and adolescents. Cochrane Database Syst Rev 2016;4(4):CD005220.
  27. Ludvigsson J. Propranolol used in prophylaxis of migraine in children. Acta Neurol Scand 1974;50(1):109-15. https://doi.org/10.1111/j.1600-0404.1974.tb01350.x
  28. Sorge F, De Simone R, Marano E, Nolano M, Orefice G, Carrieri P. Flunarizine in prophylaxis of childhood migraine. A double-blind, placebo-controlled, crossover study. Cephalalgia 1988;8(1):1-6. https://doi.org/10.1046/j.1468-2982.1988.0801001.x
  29. Forsythe WI, Gillies D, Sills MA. Propanolol ('Inderal') in the treatment of childhood migraine. Dev Med Child Neurol 1984;26(6):737-41. https://doi.org/10.1111/j.1469-8749.1984.tb08166.x
  30. Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, et al. Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. N Engl J Med 2017;376(2):115-24 https://doi.org/10.1056/NEJMoa1610384
  31. Lewis D, Winner P, Saper J, Ness S, Polverejan E, Wang S, et al. Randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of topiramate for migraine prevention in pediatric subjects 12 to 17 years of age. Pediatrics 2009;123(3):924-34. https://doi.org/10.1542/peds.2008-0642
  32. Winner P, Pearlman EM, Linder SL, Jordan DM, Fisher AC, Hulihan J. Topiramate for migraine prevention in children: a randomized, double-blind, placebo-controlled trial. Headache 2005;45(10):1304-12. https://doi.org/10.1111/j.1526-4610.2005.00262.x