The Headache in Emergency Departments study: Opioid prescribing in patients presenting with headache. A multicenter, cross‐sectional, observational study

• DOI: 10.1111/head.14217
• Publication Date: 2021-10-11T05:24:50Z
• Authors: Richard A. F. Pel...; Sinan Kamona; Kevin Chu; Amy Sweeny; Win Sen Kuan; Frances B. Kinnear; Mehmet A. Karamercan; Sharon Klim; Tissa Wijeratne; Colin A. Graham; Richard Body; Tom Roberts; Daniel Horner; Said Laribi; Gerben Keijzers; Anne‐Maree Kelly
• Keywords: Cross-sectional study

Abstract Objective To describe the patterns of opioid use in patients presenting to emergency department (ED) with nontraumatic headache by severity and geography. Background International guidelines recognize opioids are ineffective treating primary disorders. Globally, many countries experiencing an crisis. The ED can be a point initial exposure leading tolerance for patients. More geographically diverse data required inform practice. Methods This was planned, multicenter, cross‐sectional, observational substudy international Headache Emergency Departments (HEAD) study. Participants were prospectively identified throughout March 2019 from 67 hospitals Europe, Asia, Australia, New Zealand. Adult included as local site investigator. Results Overall, 4536 enrolled HEAD Opioids administered 1072/4536 (23.6%) ED, 386/3792 (10.2%) discharged High occurred prehospital Australia (190/1777, 10.7%) Zealand (55/593, 9.3%). Opioid highest these (Australia: 586/1777, 33.0%; Zealand: 221/593, 37.3%). prescription on discharge Singapore (125/442, 28.3%) Hong Kong (12/49, 24.5%). Independent predictors administration following: severe (OR 4.2, 95% CI 3.1–5.5), pre‐ED 1.42, 1.11–1.82), long‐term 1.80, 1.26–2.58). independently predicted at 8.4, 6.3–11.0). Conclusion varies internationally. Severe headache, use, administration. strong predictor discharge. These findings support education around policy ensure adherence evidence‐based interventions headache.