TY  - BOOK
AU  - Dewey, Kayla
AU  - Mazer-Amirshahi, Maryann
TI  - Trends in opioid analgesic use for headaches in US emergency departments
SN  - 0735-6757
KW  - *Analgesics, Opioid/tu [Therapeutic Use]
KW  - *Emergency Service, Hospital/td [Trends]
KW  - *Headache/dt [Drug Therapy]
KW  - Adolescent
KW  - Adult
KW  - Aged
KW  - Analgesics/tu [Therapeutic Use]
KW  - Female
KW  - Health Care Surveys
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Retrospective Studies
KW  - United States/ep [Epidemiology]
KW  - Young Adult
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Despite limited endorsement by consensus guidelines, there was increased use of opioid analgesics to treat headaches in US EDs over the past decade.Copyright � 2014 Elsevier Inc. All rights reserved; METHODS: We performed a retrospective review of the National Hospital Ambulatory Medical Care Survey, 2001 through 2010. Adult headache-related visits were identified. Medications (opioid and nonopioid) used for the treatment of headache were categorized based on medication class. Trends in ED use of the most common opioids (codeine, hydrocodone, hydromorphone, morphine, and oxycodone) were explored. The proportion of visits for which each medication was used was tabulated, and trends were analyzed using survey-weighted logistic regression; OBJECTIVE: Although not recommended as first line therapy by consensus guidelines, opioid analgesics are commonly used to treat headaches. This study evaluates trends in opioid use for headaches in US emergency departments (EDs); RESULTS: Headache visits during which any opioid was used increased between 2001 (20.6%; 95% confidence interval [CI], 18.1-23.4) and 2010 (35.0%; 95% CI, 31.8-38.4; P < .001). Prescribing of hydromorphone, morphine, and oxycodone increased, with the largest relative increase (461.1%) in hydromorphone (2001, 1.8% [95% CI, 1.2-2.6]; 2010, 10.1% [95% CI, 8.2-12.4]). Codeine use declined, and hydrocodone use remained stable. Use of opioid alternatives, including acetaminophen, butalbital, and triptans did not change over the study period, whereas use of nonsteroidal anti-inflammatory drugs increased from 26.2% (95% CI, 23.0-29.7) to 31.4% (95% CI, 28.6-34.3). Prescribing of antiemetic agents decreased from 24.1% (95% CI, 19.6-29.2) to 23.5% (95% CI, 21.1-26.0). Intravenous fluid use increased from 20.0% (95% CI, 17.0-23.4) to 34.5% (95% CI, 31.0-38.2) of visits
UR  - http://dx.doi.org/10.1016/j.ajem.2014.07.001
ER  -