Increased Disability, Reduced Quality of Life in Pediatric Patients Receiving Infusion Therapy for Migraine

Children and adolescents undergoing infusion therapy for migraine were found to have higher levels of functional disability and a lower quality of life compared with patients not receiving infusion therapy.

Children and adolescents seeking infusion therapy for recurrent migraine were found to have higher levels of functional disability and a lower quality of life compared with pediatric patients who do not seek infusion therapy, according to study results published in Headache.

The goal of the study was twofold: to capture demographic information of children and adolescents with headache disorders presenting for infusion therapy, and to determine whether any psychosocial differences exist compared with those patients who do not seek treatment (control group).

Data from patients age 6 to 19 years treated for status migrainosus or prolonged migraine attack at an outpatient headache infusion center were analyzed. Data from a subset of these patients who completed a behavioral health evaluation were included in the analyses of the second aim of the study.

Demographic information, headache characteristics, and additional medical history were extracted from each patient’s electronic medical record. Additional variables of interest included patient scores regarding overall quality of life, physical and psychosocial functioning related to physical health issues, pain coping strategies, and behavioral, social, and emotional concerns.

A total of 284 patients were included in the study (n=227 receiving infusion treatment; n=57 controls). The majority of patients were female, white, and had a mean age of 15 years. At the time of infusion, the most common headache diagnosis was status migrainosus, followed by prolonged migraine and headache attributed to traumatic injury. Patients were found to have an average length of infusion treatment of 231.5 minutes with an average pain score of 6.06/10 at the start of infusion and 2.12/10 at the end of infusion.  

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Within the secondary analysis assessing psychosocial characteristics, data from 57 participants receiving treatment were compared with that of 57 participants in the control group, matched by similar age and gender. Patients in the treatment group had higher scores for implementing pain coping strategies and lower scores for quality of life and functional disability compared with the control group. These findings underscore the need to develop concrete treatment plans and refine cognitive behavioral therapy treatment techniques.

“This study strongly supports the disabling nature of migraine among children and adolescents and its impact on the quality of life within the physical and academic domains,” the authors concluded. “Cognizance of this information can provide better understanding of patients accessing the outpatient infusion center.”

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Woods K, Ostrowski-Delahanty S, Cieplinski T, Winkelman J, Polk P, Victorio MC. Psychosocial and demographic characteristics of children and adolescents with headache presenting for treatment in a headache infusion center [published online April 22, 2019]. Headache. doi:10.1111/head.13537

This article originally appeared on Clinical Advisor