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Should A Child See a Headache Specialist? A Regional Pediatric Headache Database Review

OBJECTIVE: We propose a study to assess the impact of pediatric headache specialist in treating pediatric headaches.

BACKGROUND: Pediatric headaches are treated by a variety of health care professionals including primary healthcare providers, neurologists and headache specialists etc. In the past, it has been proposed that there is no change in outcome or care matrices when children are seen by headache specialists v/s non headache specialist. Our study aims at comparing clinical outcomes, patient education, use of resources and treatment approach among children seen by headache specialist v/s non headache specialists.

METHODS: At University of Kentucky, Children and Young Adult Headache Center, we designed a pediatric headache database to measure the care matrices and outcomes. The data of 400 children (6-17) seen by pediatric headache specialist between 8/1/2020-8/1/2021 is analyzed (figure 1).

RESULTS: The study showed that there is an exponential improvement in various care matrices. Children/care provider education scores improved from 5% to 85% (fig 2) , Barriers to treatment were assessed and addressed for 85% children (fig3). American Headache Society recommendations for investigations and treatment were followed in all of the cases

CONCLUSION: Children seen by pediatric headache specialists have better outcomes when compared to non-headache specialists. More children knew how to manage their headaches and had access to treatment at school. The headache specialist is less likely to prescribe triptan as first line rescue medicine (fig 4). The pediatric headache specialist is less likely to order neuroimaging and more likely to prescribe preventive medicines. (fig 5,6)
Keywords: Pediatric Headache Specialist, Migraine, Disability